Irreversible Hemichorea-Hemiballism in a Case of Nonketotic Hyperglycemia Presenting as the Initial Manifestation of Diabetes Mellitus

Ujjawal Roy; Shyamal Kumar Das; Adreesh Mukherjee; Debsadhan Biswas; Koushik Pan; Atanu Biswas; Ajay Panwar

doi:10.7916/D8QZ2B3F

Irreversible Hemichorea-Hemiballism in a Case of Nonketotic Hyperglycemia Presenting as the Initial Manifestation of Diabetes Mellitus

Tremor Other Hyperkinet Mov (N Y). 2016 Aug 5:6:393. doi: 10.7916/D8QZ2B3F. eCollection 2016.

Authors

Ujjawal Roy¹, Shyamal Kumar Das¹, Adreesh Mukherjee¹, Debsadhan Biswas¹, Koushik Pan¹, Atanu Biswas¹, Ajay Panwar²

Affiliations

¹ Bangur Institute of Neurosciences, IPGMER, Kolkata, India.
² King George's Medical University, Lucknow, India.

Abstract

Background: Hemichorea-hemiballism (HCHB) is a hyperkinetic movement disorder with features of both chorea and ballism occurring on the same side.

Case report: We present a case of HCHB due to nonketotic hyperglycemia (NKH) that was the initial presentation of diabetes and was irreversible clinically even after 6 months of optimal blood sugar control.

Discussion: Although HCHB due to hyperglycemia is a potentially reversible condition in the majority of patients, prolonged uncontrolled hyperglycemia may cause ischemic insult and persistent symptoms. Hyperglycemia should always be kept in the list of differentials while dealing with patients who are newly diagnosed with HCHB.

Keywords: Hemichorea–hemiballism; magnetic resonance spectroscopy; nonketotic hyperglycemia.