ACUTE CHOREO-DYSTONIA IN A NEWLY DIAGNOSED PATIENT WITH DIABETES MELLITUS: A CASE REPORT AND REVIEW OF LITERATURE

Ann Ib Postgrad Med. 2023 Aug;21(2):98-102. Epub 2023 Nov 1.

Abstract

Introduction: Diabetes mellitus is a disease with diverse macrovascular and microvascular consequences. One of the unusual effects of hyperglycemia is involuntary movement, termed hyperglycemia-induced involuntary movement. This could range from hemibalismus, chorea, choreo-atethosis, tremors to dystonia. Chorea associated with dystonia is a less commonly reported manifestation. When it is focal, it can be misdiagnosed as stroke or seizure disorder. To the best our knowledge, there is hitherto no case report in sub-Saharan Africa describing the occurrence of focal choreo-dystonia in type 2 Diabetes Mellitus.

Case presentation: Here, we present a case of a middle-aged Nigerian woman with focal choreo-dystonia of the right upper limb accompanying the diagnosis of type 2 diabetes. Achieving euglycemia with insulin resulted in complete resolution of the choreo-dystonia.

Conclusion: Doctors in resource-constrained settings should be aware of this presentation to avoid misdiagnosis and to provide prompt and goal-oriented management with a view to reducing morbidity and attendant health-care costs.

Keywords: Case report; Choreo-dystonia; Diabetes mellitus; Hyperglycemia; Involuntary movement.