J Korean Soc Radiol.  2017 Apr;76(4):294-297. 10.3348/jksr.2017.76.4.294.

Hemichorea-Hemiballismus Associated with Hyperglycemia: A Case Report

• Heo YJ
• Jeong HW

• KMID: 2373968
• DOI: http://doi.org/10.3348/jksr.2017.76.4.294

Abstract

Hemichorea-hemiballism (HCHB) associated with nonketotic hyperglycemia is the most common cause of unilateral chorea in patients with type 2 diabetes mellitus. T1-weighted MRI characteristically demonstrates hyperintensity in the contralateral corpus striatum. Here we describe a case of HCHB associated with nonketotic hyperglycemia and unusual brain involvement. A 51-year-old man presented with involuntary limb movements for several months. He had a history of diabetes mellitus and poorly controlled hyperglycemia. MRI demonstrated characteristic striatal hyperintensity, with involvement of the temporal lobe and midbrain. The patient's hyperglycemia was controlled with medication. However, his involuntary movements were reduced in terms of severity, but not eliminated, by the time of discharge. HCHB associated with hyperglycemia usually resolves rapidly after correction of blood glucose levels; thus, early recognition and glycemic control are needed to prevent an irreversible outcome.

MeSH Terms

Basal Ganglia
Blood Glucose
Brain
Chorea
Corpus Striatum
Diabetes Mellitus
Diabetes Mellitus, Type 2
Dyskinesias
Extremities
Humans
Hyperglycemia*
Magnetic Resonance Imaging
Mesencephalon
Middle Aged
Temporal Lobe
Blood Glucose

Figure

• 

  Fig. 1 MRI of a 51-year-old man with involuntary movement of the left arm and leg. A non-contrast CT scan (A) shows a hyperattenuating lesion in the right caudate nucleus and putamen. Axial T1-weighted MR images show a high signal intensity in the right caudate nucleus (head), putamen, temporal lobe (B), and the medial part of the right cerebral peduncle (C). FLAIR MR image (D) also shows high signal intensity in the right caudate nucleus (head) and putamen. FLAIR = fluid-attenuated inversion recovery

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