Hemichorea Associated with Non-ketotic Hyperglycemia: A Case Report and Review of the Literature

Qin Xu (Hai’an Hospital of traditional Chinese Medicine)
Qijun Dai (Hai’an Hospital of traditional Chinese Medicine)

Article ID: 3691

DOI: https://doi.org/10.30564/jams.v5i1.3691

Abstract


Hemichorea associated with non-ketotic hyperglycemia (HC-NH) is a rare disease. The purpose of this case report is to introduce a patient with HC-NH and provide a schedule of examination and follow-up treatment. We also reviewed the current understanding of pathophysiology and treatment and how to apply it to our patients. The case involved a 37-year-old Asian diabetic man who had a 9-day history of losing movement in left limbs and face. His initial blood glucose level was 10.13 mmol/L. HbA1c was 13.6%. Before admission, head CT scan showed suspicious small pieces of left brainstem with slightly high-density shadow and right putamen nucleus with high-density shadow. On the day of admission, head MRI showed punctate T1WI low signal shadow, T2WI high and low mixed signal shadow, T1WI high signal shadow and T2WI low signal shadow of right putamen nucleus. The case findings were consistent with his displayed motor pattern and with the HC-NH diagnosis. Gradual control of the blood glucose levels alleviates his choreiform symptoms. The endocrinology follow-up 6 months after discharge found that his symptoms did not recur after the outpatient’s medication compliance was improved. HC-NH is a rare manifestation of poor diabetes control, but it should also be noticed by clinicians. Early recognition and gradual treatment of elevated blood glucose levels seem to completely alleviate choreiform symptoms.


Keywords


Chorea; Diabetes mellitus; Nonketotic hyperglycinemia

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References


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