Hyperglycemic chorea/ballism ascertained over 15 years at a referral medical center

Hemichorea Induced by Non-ketotic Hyperglycemia in a Caucasian Woman

“…The patient showed improvement of symptoms with treatment and this is consistent with the literature [1,[3][4][5][6][7]9]. This patient was previously diagnosed with type 2 diabetes mellitus and presented with hemichorea due to chronically uncontrolled blood sugars, which is typical [6].…”

“…While this patient fits the typical elderly female with poor glucose control, she is Caucasian instead of Asian. Some cases involving Caucasian patients have been described in the United States (US) and Europe [4][5][6]. With the increasing prevalence and incidence of type 2 diabetes mellitus in the US, there are a few points to consider [8].…”

“…Hyperdensity in the basal ganglia contralateral to the hemichorea on her head CT is consistent with what has been reported in the literature. Brain MRI seems more commonly used which in those cases showed T1 putamen hyperintensity contralateral to the side of hemichorea or T2 hypodensity in the contralateral involved site [1,4,9].…”

“…One unusual acquired cause of hemichorea, isolated movement disorder to one side of the body, is hyperglycemia [3]. The prevalence of this rare complication is unknown but it is most commonly seen in the elderly Asian women population [4]. Predisposing factors include poor glucose control, female gender, and advanced age [4][5].…”

“…The prevalence of this rare complication is unknown but it is most commonly seen in the elderly Asian women population [4]. Predisposing factors include poor glucose control, female gender, and advanced age [4][5]. The treatment for this disorder involves normalization of hyperglycemia, neuroleptics, antipsychotics, and anticonvulsants if chorea persists after correction of glucose [3].…”