Hemiballismus in hyperglycemia

Knight, Agnes Kataja; Magnusson, Peter; Sjöholm, Åke

doi:10.1002/ccr3.4343

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…Similar cases are also reported worldwide [3]. The incidence of this condition seems to be very low because it occurs in fewer than 1 in 1,000,000 diabetic patients [5], especially in a setting of poor control of glycemia during-or shortly after-its acute decompensation [6][7][8]. In a broad internal survey of the Mayo Clinic concerning all the cases of chorea and ballismus, hyperglycemia, as the trigger, was discovered in 1% of them [9].…”

Section: Case Report (Figure 1)supporting

confidence: 54%

The Possible Precipitating Role of SARS-CoV-2 in a Case of Late-Onset Hemichorea Due to a Hyperosmolar Hyperglycemic State: Case Report and Brief Literature Review

Sperotto,

Ceccarelli,

Tereshko

et al. 2023

Medicina

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Case report: An 83-year-old Italian female developed postural instability and gait disturbance associated with a concomitant hyperosmolar hyperglycemic state. Brain CT and MRI scans detected a lesion in the right putamen due to metabolic derangement. A month later, the patient started suffering from choreic movements along the left side of the body with brachio-crural distribution, approximately three weeks after SARS-CoV-2 infection. She was treated with tetrabenazine with complete resolution of the aberrant movements. Any attempt to reduce tetrabenazine caused a relapse of the symptoms. Discussion: In diabetic patients, choreic syndrome should be considered a rare event with a benign prognosis and favorable response to treatment. It is the result of a condition known as “diabetic striatopathy”. The association of new-onset choreic movements, an episode of hyperglycemia, and a basal ganglia lesion is suggestive of this condition. Its pathophysiology remains unclear, and a lot of hypotheses are still debated. SARS-CoV-2 might have played a role in triggering the patient’s motor symptoms. Conclusions: Our case report agrees with the general features of those reported in the literature about movement disorders in diabetic patients. The late onset of symptoms and the poor response to treatment seem to be atypical characteristics of the syndrome. Although speculative, we cannot exclude the role of SARS-CoV-2. This case can be added to the literature for further studies and reviews.

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Section: Case Report (Figure 1)supporting

confidence: 54%

The Possible Precipitating Role of SARS-CoV-2 in a Case of Late-Onset Hemichorea Due to a Hyperosmolar Hyperglycemic State: Case Report and Brief Literature Review

Sperotto,

Ceccarelli,

Tereshko

et al. 2023

Medicina

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Hemichorea Associated with Non-Ketotic Hyperglycemia: 1 Case Report and a Review of the Literature

张¹

2022

ACM

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Relationship Between Diabetic Chorea and Timing of MRI Findings: A Systematic Review with Case Reports

Otaka,

Harada,

Sugawara

et al. 2023

IJGM

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Background Diabetic chorea is a rare complication of diabetes mellitus for which head MRI is the most common diagnostic imaging modality. Cases have been reported where CT and/or MRI findings are inconsistent or clinical symptoms and imaging findings do not appear simultaneously. We aimed to compile the cases in which imaging findings appeared on MRI retests and to examine in a systematic review whether temporal differences in the appearance of imaging findings correlate with clinical characteristics. Case Presentation An 80-year-old man with type 2 diabetes mellitus came to a hospital with abnormal movements of the left upper and lower extremities. Two days after the first visit, his symptoms flared up, and his head MRI showed an old cerebral infarction and no new lesion. On day 14, he retested T1-weighted imaging and showed a high signal in the right putamen, which was considered diabetic chorea. Blood glucose was controlled with insulin, and the involuntary movements disappeared. Methods PubMed and ICHUSHI were searched to identify patients with diabetic chorea who had undergone MRI retests. Patients grouped by the temporal change in the presence/absence of imaging findings were compared on age, sex, duration of diabetes mellitus, blood glucose level, HbA1c level, side of involuntary movement, time to first MRI, and follow-up MRI. Results Of the 64 cases analyzed, 43 (67.2%) were female. The mean age was 69.0 years. 16 (25.0%) had worsening findings upon MRI retesting, 37 (57.8%) had improvement, and 10 (15.6%) had unchanged findings. There were no significant differences in age, sex, mean blood glucose level or HbA1c at onset among the groups. Conclusion There was no association between the pattern of appearance of imaging findings over time and clinical characteristics, including glucose levels. If initial MRI findings are negative, MRI retesting after a certain time may help diagnose diabetic chorea.

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Hemiballismus in hyperglycemia

Abstract: Diabetes may cause late complications in the CNS but certain lesions may also occur acutely in hyperglycemia. We describe a case of hyperosmolar non‐ketotic syndrome and reversible hemichoreic dyskinesia with morphological changes in basal ganglia.

Cited by 3 publications

References 4 publications

The Possible Precipitating Role of SARS-CoV-2 in a Case of Late-Onset Hemichorea Due to a Hyperosmolar Hyperglycemic State: Case Report and Brief Literature Review

The Possible Precipitating Role of SARS-CoV-2 in a Case of Late-Onset Hemichorea Due to a Hyperosmolar Hyperglycemic State: Case Report and Brief Literature Review

Hemichorea Associated with Non-Ketotic Hyperglycemia: 1 Case Report and a Review of the Literature

Relationship Between Diabetic Chorea and Timing of MRI Findings: A Systematic Review with Case Reports

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