Open AccessHemi-Chorea in a Patient with Ketotic hyperglycemia: An Unusual Presentation
Author(s) -
P Satish,
Pujitha Kudaravalli,
Neha Agrawal,
Thomas Mathew,
Sudha Vidyasagar
Publication year - 2017
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2017/27266.9939
Subject(s) - chorea , medicine , basal ganglia , ketosis , presentation (obstetrics) , basal (medicine) , hyperintensity , diabetes mellitus , insulin , endocrinology , surgery , magnetic resonance imaging , central nervous system , disease , radiology
Chorea has often been associated with lesions in the basal ganglia and in the sub thalamic nucleus. It is possible for a patient with chorea-ballismus to have hyperglycemia at the initial presentation. We hereby present a case of an 81-year-old female, who was on treatment for type 2 diabetes mellitus and presented to us with sub acute onset of abnormal movements of right side of the body. She had semi purposeful, rapid and jerky movements of right upper limb and lower limb along with abnormal tongue movements. Laboratory data showed very high blood glucose levels, urine ketones were positive and pH of arterial blood was normal. MRI brain showed hyperintensities in right basal ganglia. So, hyperglycemia induced hemichorea was considered as a possibility and she was treated with insulin. These abnormal movements decreased subsequently with treatment and patient is doing better in the follow-up visits. This presentation is extremely rare, as review of literature showed similar presentations in patients with non ketotic hyperglycemia but not reported so far in diabetic ketosis.