Chorea-Ballism as a Manifestation of Decompensated Type 2 Diabetes Mellitus

Chang, Claudia Veiga; Matsubara, Luiz Shiguero; Duarte, Daniela Rezende; Okoshi, Marina Politi; Felı́cio, André Carvalho; Godeiro-Júnior, Clécio; Ferraz, Henrique Ballalai

doi:10.1097/maj.0b013e3180318e34

Cited by 28 publications

(44 citation statements)

References 19 publications

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“…Unilateral involvement in chorea induced by nonketotic hyperglycemia is more common in the literature than generalized chorea, which is the opposite of what we should expect from a central nervous system disorder provoked by a metabolic abnormality [2,6]. Also, putamen is the most consistent focus in hyperglycemiarelated chorea [2,8].…”

Section: Discussionmentioning

confidence: 81%

“…Resolution of the lesions seen in Case Reports in Endocrinology imaging studies was found to be slower than the clinical course [6,8,11]. Our patient had a rapid symptomatic remission after correction of hyperglycemia.…”

Section: Discussionmentioning

confidence: 84%

“…Chorea-ballism can be rapidly controlled by normalization of glycemia [5,6]. Resolution of the lesions seen in Case Reports in Endocrinology imaging studies was found to be slower than the clinical course [6,8,11].…”

Section: Discussionmentioning

confidence: 99%

“…[10]. Chorea or ballismus can be caused by a variety of disorders affecting the basal ganglia such as metabolic diseases (it is possible for a patient with chorea-ballismus to have hyperglycemia at the initial presentation) [1,6,8], hypoxic-ischemic events, vascular disorders, structural abnormalities, trauma, drugs and toxins, infections, and inflammatory immunological diseases (rheumatic fever-Sydenham's chorea, systemic lupus erythematosus) [1,4,5,8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Focal epilepsy, transient chorea or ballism provoked by an episode of nonketotic hyperglycemia (NKH) in adults with type 2 diabetes [1][2][3][4][5][6][7][8], and ketotic hyperglycemia in children with type I diabetes mellitus have been reported [9]. Nonketotic hyperglycemia occurs more often in women [1,3,6] and usually is associated with very high blood glucose [3]. In these cases, the seizures [7] as well as the choreiform movements have resolved within days to a few weeks after normalization of blood glucose and hence, reversible metabolic derangements within the basal ganglia have often been assumed [1-4, 8, 9].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Monoballism associated with newly onset ketotic Hyperglycemia

Soysal

Gelen²,

Hizar³

et al. 2013

EJEA

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Monoballism associated with newly onset ketotic Hyperglycemia

Soysal

Gelen²,

Hizar³

et al. 2013

EJEA

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Diabetic hemiballismus in the context of euglycaemia

et al. 2021

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An 84‐year‐old white British woman with a background history of type 2 diabetes, Alzheimer's dementia, gout and hypothyroidism presented with a four‐day history of sudden, involuntary left arm and left leg movements. She had venous blood glucose of 4.4mmol/L with normal pH on admission. She had normal inflammatory markers with no signs of acute infection. Initial computed tomography brain imaging showed a known stable meningioma with no acute haemorrhage or infarct. Of note she had an admission, six weeks prior, with falls and raised capillary blood glucose readings. On that admission, her HbA1c was noted to have increased to 146mmol/mol having been 57mmol/mol six months earlier. Her oral hypoglycaemic agents were up‐titrated. There was no documented episode of hyperosmolar hyperglycaemic state. Brain magnetic resonance imaging (MRI with contrast) showed right striatal T1 high signal typical of diabetes‐related hemiballismus. She was treated with tetrabenazine for two weeks which was stopped before discharge as there was complete resolution of involuntary arm and leg movements. Hemiballismus is a rare but well‐known complication of diabetes. It is typically seen in the setting of hyperglycaemia. Our patient presented with hemiballismus while euglycaemic in the setting of recent hyperglycaemia. Copyright © 2021 John Wiley & Sons.

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Hypoglycemia-induced hemichorea in a patient with Fahr’s syndrome

Paraskevas

Vlachos²,

Vassilopoulou³

et al. 2012

Neurol Sci

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Non-ketotic hyperglycemia may be a cause of hemiballism-hemichorea. We present an elderly female type II diabetic patient with right-sided hemiballism-hemichorea of acute onset during hypoglycemia following insulin overtreatment of non-ketotic hyperglycemia. Brain computerized tomography and magnetic resonance imaging scans revealed characteristic hyperdensity and T1 hyperintensity, respectively, in the left basal ganglia, in addition to pallido-dentate calcifications, suggestive of Fahr's syndrome. Although extremely rare, hypoglycemia may be a cause of hemiballism-hemichorea especially in the presence of predisposing factors such as previous hyperglycemic episodes and Fahr's syndrome.

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Chorea-Ballism as a Manifestation of Decompensated Type 2 Diabetes Mellitus

Cited by 28 publications

References 19 publications

Monoballism associated with newly onset ketotic Hyperglycemia

Monoballism associated with newly onset ketotic Hyperglycemia

Diabetic hemiballismus in the context of euglycaemia

Hypoglycemia-induced hemichorea in a patient with Fahr’s syndrome

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