Korean J Fam Med.  2018 May;39(3):200-203. 10.4082/kjfm.2018.39.3.200.

Hemiballismus in Uncontrolled Diabetes Mellitus

• Jaafar J
• Rahman RA
• Draman N
• Yunus NA

• KMID: 2418276
• DOI: http://doi.org/10.4082/kjfm.2018.39.3.200

Abstract

Hemiballismus, a subtype of chorea, is a rare movement disorder, and is most commonly found secondary to stroke. Movements are involuntary, violent, coarse, and have a wide amplitude. There is increasing report of hemiballismus occurring in non-ketotic hyperglycemia. Spontaneous improvements or remissions were observed in many patients, and treatment should be directed towards the cause of hemiballismus. There is no randomized control trial to guide clinicians in deciding the best treatment option when managing hemiballismus. Symptomatic treatment includes the use of drugs such as dopamine receptor blocker and tetrabenazine. Surgical treatment is reserved for severe, persistent, and disabling hemiballismus. This case is of an elderly woman with long standing uncontrolled diabetes who presented with abnormal movement in her left upper limb for 2 months, which resolved slowly with good control of her glucose levels. Treating physicians need to have a high index of suspicion to prevent mismanagement of the condition.

Keyword

Hemiballismus; Chorea; Choreiform Movement; Abnormal Movements; Diabetes Mellitus; Dyskinesias

MeSH Terms

Aged
Chorea
Diabetes Mellitus*
Dyskinesias*
Female
Glucose
Humans
Hyperglycemia
Movement Disorders
Receptors, Dopamine
Stroke
Tetrabenazine
Upper Extremity
Glucose
Receptors, Dopamine
Tetrabenazine