Soonchunhyang Med Sci.  2013 Jun;19(1):34-37.

Two Cases of Hemichorea Associated with Nonketotic Hyperglycemia in Type 2 Diabetes Mellitus Patient

• Kim JH
• Park HK

Abstract

Hemichorea-hemiballism is a rare complication of nonketotic hyperglycemia in type 2 diabetes mellitus (T2DM). It can be complicated in long-standing type 1 diabetes mellitus or T2DM, and has been described as a presenting symptom of new-onset diabetes. Rapid correction of diabetic ketoacidosis may also cause the delayed hemichorea. Although hyperglycemic hemiballism rarely causes generalized chorea due to bilateral basal ganglia involvement, patients typically present with hemichorea developing over days to months in the setting of elevated serum glucose. On T1-weighted brain magnetic resonance imaging and computed tomography scan a high signal intensity lesion at the basal ganglia is characteristic. After the correction of hyperglycemia, the movements generally disappear within hours, but atypical cases with delayed onset after the resolution of hyperglycemia, unremitting severe movements, and late recurrence are also reported. We report two cases of female T2DM patients who presented with hemichorea. One patient presented with hemichorea in nonketotic hyperglycemia, and the other with delayed onset hemichorea after the resolution of hyperglycemia.

Keyword

Hemichorea-hemiballism; Nonketotic hyperglycemia; Type 2 diabetes mellitus

MeSH Terms

Basal Ganglia
Brain
Chorea
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Diabetic Ketoacidosis
Dyskinesias
Female
Glucose
Humans
Hyperglycemia
Magnetic Resonance Imaging
Recurrence
Glucose