Hemiballismus in Patients With Poorly Controlled Type 2 Diabetes Mellitus

Chakales, Pressley

doi:10.12788/fp.0006

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…In HHS-associated hemiballismus, symptoms eventually resolve with an improvement of hyperglycemia [ 10 ]. These specific patients tend to have a favorable prognosis if they maintain adequate glycemic control [ 10 , 11 ]. Occasionally, medications such as benzodiazepines, neuroleptics, and antiepileptics are also utilized [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Consideration for Hemiballismus in the Differential Diagnosis: A Rare Case of Hyperosmolar Hyperglycemic State

Isayli¹,

Ulloa²,

Childress³

2022

Cureus

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We present a case of a 58-year-old male with a past medical history of hypertension and diabetes mellitus presenting to the emergency department with a complaint of abnormal and uncontrollable right arm jerking motions occurring since the afternoon on the day prior to presentation. Arm movements such as these may be consistent with either focal seizures or hemiballismus, a movement disorder classified as a choreiform subtype consisting of involuntary violent movements of an extremity with wide amplitudes. Although oftentimes focal seizures and hemiballismus are associated with neurologic etiologies such as strokes, the second most common cause of hemiballismus appears to be non-ketotic hyperosmolar hyperglycemia. While symptomatic treatment in managing focal seizures and hemiballismus may consist of benzodiazepines and dopamine receptor antagonists, respectively, it is important to treat the underlying cause, which in this case was the non-ketotic hyperosmolar hyperglycemic state associated with this patient's long-standing history of poorly controlled diabetes mellitus.

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Section: Discussionmentioning

confidence: 99%

Consideration for Hemiballismus in the Differential Diagnosis: A Rare Case of Hyperosmolar Hyperglycemic State

Isayli¹,

Ulloa²,

Childress³

2022

Cureus

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“…Normalization of blood glucose typically resolves chorea symptoms, however there are known cases of chorea continuing for weeks even after correction of hyperglycemia [ 5 , 6 ]. For addressing chorea symptoms, dopamine antagonists such as typical and atypical antipsychotics along with vesicular monoamine transporter (VMAT) inhibitors such as tetrabenazine can be used as first-line treatments [ 7 ]. Notably, the presence of chronic medical illness and use of steroids may worsen the prognosis of this condition [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Hemiballismus–hemichorea syndrome in an acute rehabilitation setting: two case reports

Tsai

Shekhtman²,

Stenquist³

et al. 2022

J Med Case Reports

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Background We report two similar cases of patients diagnosed with hemiballismus–hemichorea syndrome secondary to uncontrolled hyperglycemia. Both patients were treated at an inpatient rehabilitation center and made a significant recovery in both function and activities of daily living. Although hemiballismus–hemichorea syndrome has known pharmacological treatments, little has been reported on the effectiveness of acute rehabilitation on managing and treating this syndrome. Case presentation The first case involves a 44-year-old Hispanic male with past medical history of type 2 diabetes mellitus, hypertension, anxiety, and depression who presented with continuous, uncontrollable, unilateral movements 1 month following a hospital admission for hyperglycemia. Magnetic resonance imaging findings showed lesions in the basal ganglia, confirming the diagnosis of hemiballismus–hemichorea syndrome. The patient was started on antipsychotic medications and antihyperglycemic medications controlling glucose levels, but continued to have hemiballismus symptoms. The second case involves a 78-year-old Haitian female with past medical history of type 2 diabetes mellitus and hypertension who presented with weakness and continuous, involuntary movements in her upper and lower extremities 1 month following a hospital admission for hyperglycemia and encephalopathy. Magnetic resonance imaging findings were positive for bilateral lesions in the basal ganglia, establishing a diagnosis of hemiballismus–hemichorea syndrome. After a 2-week stay at an acute rehabilitation center, both patients made a significant recovery in function and activities of daily living. Conclusion The aim in presenting these cases is to elucidate the etiology and progression of a rare disease process known as hemiballismus–hemichorea syndrome and to provide evidence for the potential positive impact of acute rehabilitation on patients with unresolved hemiballismus–hemichorea following an episode of hyperglycemia.

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Hemiballismus in Patients With Poorly Controlled Type 2 Diabetes Mellitus

Abstract: Swift identification of hemiballismus as a complication of poorly controlled type 2 diabetes mellitus may help facilitate optimal care through glycemic control and prevent debilitating loss of patients' function and autonomy, prolonged hospital stays, and overuse of resources.

Cited by 2 publications

References 13 publications

Consideration for Hemiballismus in the Differential Diagnosis: A Rare Case of Hyperosmolar Hyperglycemic State

Consideration for Hemiballismus in the Differential Diagnosis: A Rare Case of Hyperosmolar Hyperglycemic State

Hemiballismus–hemichorea syndrome in an acute rehabilitation setting: two case reports

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