Abstract
Chorea can be caused by a variety of diseases, including neurodegenerative disorders, vascular events, toxic-metabolic states, and immunologic and infectious diseases. We describe a patient who presented with hemichorea as the initial manifestation of Diabetes Mellitus (DM) and responded partially to the glycemic control. A 63-year-old, healthy Hispanic man with no prior history of medical illness presented with subacute onset, gradually progressive hemichorea of 6 weeks' duration. On evaluation, he was found to have non-ketotic hyperglycemia with high serum glucose (328 mg/dL), elevated hemoglobin A1C (9.9%), and absent ketones. Magnetic Resonance Imaging of the brain demonstrated hyper intense signals in bilateral basal ganglia on T1W images. He was diagnosed to have DM. Despite optimal glycemic control with insulin, the patient continued to have hemichorea at 3 months follow-up and required haloperidol for control of the involuntary movements. Involuntary movements, particularly hemichorea, can be a manifestation and rarely be a presenting sign of DM.
References
Jul 1, 1990·Stroke; a Journal of Cerebral Circulation·I AltafullahS Taylor
Mar 1, 1984·Archives of Neurology·R P Newman, W R Kinkel
Jun 1, 1994·Journal of Neurology, Neurosurgery, and Psychiatry·J J Lin, M K Chang
Oct 13, 2001·Journal of Neurology·J J LinW C Shen
Dec 18, 2001·Movement Disorders : Official Journal of the Movement Disorder Society·J E AhlskogK A Gwinn-Hardy
Sep 21, 2002·Journal of Neurology·Mark M SalehJonathan S Katz
Jun 1, 1960·Neurology·S F BEDWELL
Jan 13, 2005·Journal of Neurology·Jung Lung HsuWei-Chih Hsu
Jun 21, 2005·Clinical Neuropharmacology·Erika Driver-Dunckley, Virgilio Gerald H Evidente
Sep 30, 2005·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·D BrancaU Aguglia
Jan 18, 2006·Internal Medicine·Hiroyuki OhmoriMakoto Uchino
Nov 13, 2008·Neurology·Sarah M KranickHoward I Hurtig
Jan 29, 2013·BMJ Case Reports·Rajesh Verma, Anupam Jaiswal
Nov 19, 2013·BMJ Case Reports·Rajesh Verma, Heramba Narayan Praharaj
Citations
Sep 4, 2015·Journal of Community Hospital Internal Medicine Perspectives·Robert P Ferguson
Jan 24, 2017·Somatosensory & Motor Research·Hafiz Khuram RazaHao Chen
Feb 2, 2020·Scientific Reports·Choon-Bing ChuaI-Ting Tsai
Mar 12, 2020·Frontiers in Neurology·Wei ZhengJing-Yuan Lin