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Hemichorea-Hemiballism Secondary to Non-Ketotic Hyperglycemia.

Pinsker JE, Shalileh K, Rooks VJ, Pinsker RW - J Clin Med Res (2015)

Bottom Line: CT scan and MR demonstrated left basal ganglia abnormalities suggesting hyperglycemia-related hemichorea-hemiballismus syndrome.Restoration of euglycemia led to eventual resolution of all symptoms.Knowledge of this disorder is paramount so as to rule out other causes of intracranial pathology.

View Article: PubMed Central - PubMed

Affiliation: William Sansum Diabetes Center, Santa Barbara, CA, USA.

ABSTRACT
Non-ketotic hyperglycemia is an unusual and rare cause of hemichorea-hemiballismus. Correction of the hyperglycemia usually results in total resolution of the signs and symptoms. We present the case and medical imaging findings of a 66-year-old female who presented with steadily worsening choreiform and ballistic movements of the right upper and lower extremities over a 2-week period. Her serum glucose was greater than 600 mg/dL, and no ketones were present. CT scan and MR demonstrated left basal ganglia abnormalities suggesting hyperglycemia-related hemichorea-hemiballismus syndrome. Restoration of euglycemia led to eventual resolution of all symptoms. Knowledge of this disorder is paramount so as to rule out other causes of intracranial pathology.

No MeSH data available.


Related in: MedlinePlus

There was minimal increased signed intensity on the diffusion-weighted imaging sequence (arrow) (a), as well as T1 shine through on the time of flight sequence (arrow) (b).
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Figure 2: There was minimal increased signed intensity on the diffusion-weighted imaging sequence (arrow) (a), as well as T1 shine through on the time of flight sequence (arrow) (b).

Mentions: Physical examination was remarkable for choreiform and ballistic movements of the right upper and lower extremities. These movements did not lessen with sleep. Laboratory evaluation again showed severe hyperglycemia without evidence of ketonemia. CT scan and MR with diffusion-weighted imaging showed abnormalities in the left basal ganglia suggesting possible hyperglycemia-related hemichorea-hemiballismus syndrome with no evidence of stroke (Fig. 1, 2). Aggressive insulin treatment led to eventual resolution of her abnormal movements, although they did not fully resolve until almost 1 month later.


Hemichorea-Hemiballism Secondary to Non-Ketotic Hyperglycemia.

Pinsker JE, Shalileh K, Rooks VJ, Pinsker RW - J Clin Med Res (2015)

There was minimal increased signed intensity on the diffusion-weighted imaging sequence (arrow) (a), as well as T1 shine through on the time of flight sequence (arrow) (b).
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4522995&req=5

Figure 2: There was minimal increased signed intensity on the diffusion-weighted imaging sequence (arrow) (a), as well as T1 shine through on the time of flight sequence (arrow) (b).
Mentions: Physical examination was remarkable for choreiform and ballistic movements of the right upper and lower extremities. These movements did not lessen with sleep. Laboratory evaluation again showed severe hyperglycemia without evidence of ketonemia. CT scan and MR with diffusion-weighted imaging showed abnormalities in the left basal ganglia suggesting possible hyperglycemia-related hemichorea-hemiballismus syndrome with no evidence of stroke (Fig. 1, 2). Aggressive insulin treatment led to eventual resolution of her abnormal movements, although they did not fully resolve until almost 1 month later.

Bottom Line: CT scan and MR demonstrated left basal ganglia abnormalities suggesting hyperglycemia-related hemichorea-hemiballismus syndrome.Restoration of euglycemia led to eventual resolution of all symptoms.Knowledge of this disorder is paramount so as to rule out other causes of intracranial pathology.

View Article: PubMed Central - PubMed

Affiliation: William Sansum Diabetes Center, Santa Barbara, CA, USA.

ABSTRACT
Non-ketotic hyperglycemia is an unusual and rare cause of hemichorea-hemiballismus. Correction of the hyperglycemia usually results in total resolution of the signs and symptoms. We present the case and medical imaging findings of a 66-year-old female who presented with steadily worsening choreiform and ballistic movements of the right upper and lower extremities over a 2-week period. Her serum glucose was greater than 600 mg/dL, and no ketones were present. CT scan and MR demonstrated left basal ganglia abnormalities suggesting hyperglycemia-related hemichorea-hemiballismus syndrome. Restoration of euglycemia led to eventual resolution of all symptoms. Knowledge of this disorder is paramount so as to rule out other causes of intracranial pathology.

No MeSH data available.


Related in: MedlinePlus