Nonketotic hyperglycemia hemichorea and hemiballismus: a case report
Abstract Background Diabetic striatopathy, also known as hyperglycemic hemichorea-hemiballismus, is a rare movement disorder associated with nonketotic hyperglycemia in patients with poorly controlled diabetes mellitus. The pathophysiology is not fully elucidated but may involve hyperviscosity, isch...
| Tác giả chính: | |
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| Định dạng: | Bài viết |
| Ngôn ngữ: | English |
| Được phát hành: |
BMC
2024-03-01
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| Loạt: | Journal of Medical Case Reports |
| Những chủ đề: | |
| Truy cập trực tuyến: | https://doi.org/10.1186/s13256-023-04332-y |
| _version_ | 1827315961076645888 |
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| author | Abhishek Dixit |
| author_facet | Abhishek Dixit |
| author_sort | Abhishek Dixit |
| collection | DOAJ |
| description | Abstract Background Diabetic striatopathy, also known as hyperglycemic hemichorea-hemiballismus, is a rare movement disorder associated with nonketotic hyperglycemia in patients with poorly controlled diabetes mellitus. The pathophysiology is not fully elucidated but may involve hyperviscosity, ischemia, and alterations in basal ganglia neurotransmitters. Case presentation We present a case of a 64-year-old Asian female patient with longstanding poorly controlled type 2 diabetes mellitus who developed abrupt-onset right-sided hemichorea-hemiballismus. Laboratory results showed hyperglycemia without ketoacidosis. Neuroimaging revealed left putaminal hyperdensity on computed tomography and T1 hyperintensity on magnetic resonance imaging. With insulin therapy and tetrabenazine, her movements improved but persisted at 1-month follow-up. Discussion This case illustrates the typical features of diabetic striatopathy, including acute choreiform movements contralateral to neuroimaging abnormalities in the setting of nonketotic hyperglycemia. While neuroleptics may provide symptomatic relief, prompt glycemic control is critical given the risk of recurrence despite imaging normalization. Conclusion Diabetic striatopathy should be recognized as a rare disorder that can occur with poorly controlled diabetes. Further study of its pathophysiological mechanisms is needed to better guide management. Maintaining tight glycemic control is essential to prevent recurrence of this debilitating movement disorder. |
| first_indexed | 2024-04-24T23:05:44Z |
| format | Article |
| id | doaj.art-3eb3dc0feeb24cbf8046db2713ea7abb |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-24T23:05:44Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-3eb3dc0feeb24cbf8046db2713ea7abb2024-03-17T12:27:17ZengBMCJournal of Medical Case Reports1752-19472024-03-011811310.1186/s13256-023-04332-yNonketotic hyperglycemia hemichorea and hemiballismus: a case reportAbhishek Dixit0Department of Neurology, Institute of Medical Science, Banaras Hindu UniversityAbstract Background Diabetic striatopathy, also known as hyperglycemic hemichorea-hemiballismus, is a rare movement disorder associated with nonketotic hyperglycemia in patients with poorly controlled diabetes mellitus. The pathophysiology is not fully elucidated but may involve hyperviscosity, ischemia, and alterations in basal ganglia neurotransmitters. Case presentation We present a case of a 64-year-old Asian female patient with longstanding poorly controlled type 2 diabetes mellitus who developed abrupt-onset right-sided hemichorea-hemiballismus. Laboratory results showed hyperglycemia without ketoacidosis. Neuroimaging revealed left putaminal hyperdensity on computed tomography and T1 hyperintensity on magnetic resonance imaging. With insulin therapy and tetrabenazine, her movements improved but persisted at 1-month follow-up. Discussion This case illustrates the typical features of diabetic striatopathy, including acute choreiform movements contralateral to neuroimaging abnormalities in the setting of nonketotic hyperglycemia. While neuroleptics may provide symptomatic relief, prompt glycemic control is critical given the risk of recurrence despite imaging normalization. Conclusion Diabetic striatopathy should be recognized as a rare disorder that can occur with poorly controlled diabetes. Further study of its pathophysiological mechanisms is needed to better guide management. Maintaining tight glycemic control is essential to prevent recurrence of this debilitating movement disorder.https://doi.org/10.1186/s13256-023-04332-yDiabetic striatopathyHyperglycemic hemichorea-hemiballismusNonketotic hyperglycemiaType 2 diabetes mellitusPutaminal hyperdensityNeurotransmitter alterations |
| spellingShingle | Abhishek Dixit Nonketotic hyperglycemia hemichorea and hemiballismus: a case report Journal of Medical Case Reports Diabetic striatopathy Hyperglycemic hemichorea-hemiballismus Nonketotic hyperglycemia Type 2 diabetes mellitus Putaminal hyperdensity Neurotransmitter alterations |
| title | Nonketotic hyperglycemia hemichorea and hemiballismus: a case report |
| title_full | Nonketotic hyperglycemia hemichorea and hemiballismus: a case report |
| title_fullStr | Nonketotic hyperglycemia hemichorea and hemiballismus: a case report |
| title_full_unstemmed | Nonketotic hyperglycemia hemichorea and hemiballismus: a case report |
| title_short | Nonketotic hyperglycemia hemichorea and hemiballismus: a case report |
| title_sort | nonketotic hyperglycemia hemichorea and hemiballismus a case report |
| topic | Diabetic striatopathy Hyperglycemic hemichorea-hemiballismus Nonketotic hyperglycemia Type 2 diabetes mellitus Putaminal hyperdensity Neurotransmitter alterations |
| url | https://doi.org/10.1186/s13256-023-04332-y |
| work_keys_str_mv | AT abhishekdixit nonketotichyperglycemiahemichoreaandhemiballismusacasereport |