A Rare Case of Hemichorea-Hemiballismus Due to Chronic Uncontrolled Hyperglycemia

Khan, Qalb; Batool, Anisa; Haider, Muhammad Adnan; Hanif, Muhammad; Khan, Abdul Wali

doi:10.7759/cureus.10861

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…ODS manifests with a variety of clinical presentations, including altered consciousness/encephalopathy, dysphagia, and limb weakness [ 2 ]. The underlying cause and pathogenesis of ODS remain unclear; however, numerous studies have implicated the rapid correction of hyponatremia as the primary factor associated with CPM, resulting in damage to specific brain regions, particularly the pontine white matter tracts [ 3 ]. Although other causes have been suggested, a limited number of cases have reported an association between ODS and alcohol withdrawal.…”

Section: Introductionmentioning

confidence: 99%

A Case of Alcohol Withdrawal-Induced Central and Extrapontine Myelinolysis

Jamil,

Salam,

Joseph Benher

et al. 2023

Cureus

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A 40-year-old female with a history of chronic alcohol use disorder presented with an acute intractable left-sided headache for three days and progressively worsening unsteady gait requiring a wheelchair to ambulate. The patient had a history of chronic alcoholism since 2019 but reported abstinence since September 2021. One month after quitting alcohol, she experienced a sudden deterioration in bilateral extremity neuropathy, forgetfulness, difficulty writing, and severe mood swings, which continued to worsen until her presentation in July 2022. Laboratory tests, including complete blood count and electrolyte levels, were within normal ranges. A previous MRI performed during the investigation for alcoholic neuropathy a few months before she quit drinking showed no abnormalities. However, a subsequent MRI during work-up for the current acute symptoms revealed significant signal abnormalities involving the central pons, bilateral cerebral peduncles, and medullary pyramids, consistent with chronic central pontine myelinolysis (CPM) with extrapontine myelinolysis (EPM) extending into the peduncles. The patient received treatment with folate and multivitamins and was scheduled for outpatient follow-up with physical therapy for rehabilitation. This case highlights CPM as a consequence of alcohol withdrawal and emphasizes the importance of timely diagnosis and appropriate management in such patients.

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Section: Introductionmentioning

confidence: 99%