Non-ketotic Hyperglycaemic Hemichorea with Unilateral Magnetic Resonance Imaging Putaminal Hyperintensity

Abstract

ABS TRACT Non-ketotic hyperglycaemic hemichorea is a rare syndrome characterized by a triad of hemichorea, hyperglycemia, and peculiar imaging abnormalities. Regression of symptoms is typically associated with normalisation of serum glucose levels and plasma osmolality. An 85 year-old female was admitted to the neurology clinic with left-sided involuntary movements. Magnetic resonance imaging of brain demonstrated hyperintensity on T1 weighted images. She was treated with clonazepam (12. 5 mg/ day) for symptomatic therapy. Hyperglycaemia was controlled using a combined therapy with insulin aspart and insülin glargine. The patient showed prompt improvement in her involuntary movements in a day. Acute or subacute onset of unilateral involuntary movements should suggest non-ketotic hyperglycaemic hemichorea, the recognition of which may result in prompt control of the symptoms by normalization of blood glucose.