Hemi-Chorea in a Patient with Ketotic Hyperglycemia: An Unusual Presentation
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 mell...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2017-05-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/9939/27266_CE(RA1)_F(T)_PF1(P_PG)_PFA(PG_SS).pdf |
| _version_ | 1819111095552442368 |
|---|---|
| author | Pendela Venkata Satish Kudaravalli Pujitha Neha Agrawal Thomas Mathew Sudha Vidyasagar |
| author_facet | Pendela Venkata Satish Kudaravalli Pujitha Neha Agrawal Thomas Mathew Sudha Vidyasagar |
| author_sort | Pendela Venkata Satish |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T03:52:10Z |
| format | Article |
| id | doaj.art-796d6676dbfe41dc92af7dd2de11fb21 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-22T03:52:10Z |
| publishDate | 2017-05-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-796d6676dbfe41dc92af7dd2de11fb212022-12-21T18:39:58ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-05-01115OD24OD2510.7860/JCDR/2017/27266.9939Hemi-Chorea in a Patient with Ketotic Hyperglycemia: An Unusual PresentationPendela Venkata Satish0Kudaravalli Pujitha1Neha Agrawal2Thomas Mathew3Sudha Vidyasagar4Junior Resident, Department of Medicine, K.M.C., Manipal, Karnataka, India.House Surgeon, Department of Medicine, K.M.C., Manipal, Karnataka, India.Junior Resident, Department of Medicine, K.M.C., Manipal, Karnataka, India.Junior Resident, Department of Medicine, K.M.C., Manipal, Karnataka, India.Professor and Head, Department of Medicine, K.M.C., Manipal, Karnataka, India.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.https://jcdr.net/articles/PDF/9939/27266_CE(RA1)_F(T)_PF1(P_PG)_PFA(PG_SS).pdfchoreo-athetoid movementsdiabetic ketosistype 2 diabetes mellitus |
| spellingShingle | Pendela Venkata Satish Kudaravalli Pujitha Neha Agrawal Thomas Mathew Sudha Vidyasagar Hemi-Chorea in a Patient with Ketotic Hyperglycemia: An Unusual Presentation Journal of Clinical and Diagnostic Research choreo-athetoid movements diabetic ketosis type 2 diabetes mellitus |
| title | Hemi-Chorea in a Patient with Ketotic Hyperglycemia: An Unusual Presentation |
| title_full | Hemi-Chorea in a Patient with Ketotic Hyperglycemia: An Unusual Presentation |
| title_fullStr | Hemi-Chorea in a Patient with Ketotic Hyperglycemia: An Unusual Presentation |
| title_full_unstemmed | Hemi-Chorea in a Patient with Ketotic Hyperglycemia: An Unusual Presentation |
| title_short | Hemi-Chorea in a Patient with Ketotic Hyperglycemia: An Unusual Presentation |
| title_sort | hemi chorea in a patient with ketotic hyperglycemia an unusual presentation |
| topic | choreo-athetoid movements diabetic ketosis type 2 diabetes mellitus |
| url | https://jcdr.net/articles/PDF/9939/27266_CE(RA1)_F(T)_PF1(P_PG)_PFA(PG_SS).pdf |
| work_keys_str_mv | AT pendelavenkatasatish hemichoreainapatientwithketotichyperglycemiaanunusualpresentation AT kudaravallipujitha hemichoreainapatientwithketotichyperglycemiaanunusualpresentation AT nehaagrawal hemichoreainapatientwithketotichyperglycemiaanunusualpresentation AT thomasmathew hemichoreainapatientwithketotichyperglycemiaanunusualpresentation AT sudhavidyasagar hemichoreainapatientwithketotichyperglycemiaanunusualpresentation |