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Case Reports
. 2013 Dec;50(4):375-378.
doi: 10.4274/npa.y6468. Epub 2013 Dec 1.

Chorea-Ballismus Associated with Hyperglycemia

Elif Kocasoy Orhan  1 , M Mert Atmaca  1 , Melek Atmaca  2 , Haşmet A Hanağasi  1
Affiliations
Case Reports

Chorea-Ballismus Associated with Hyperglycemia

Elif Kocasoy Orhan et al. Noro Psikiyatr Ars. 2013 Dec.

Abstract
in English, Turkish

Chorea-ballismus which is a rare complication of nonketotic hyperglycemia may be the first symptom of type 2 diabetes mellitus. In this paper, we present two patients, who had involuntary movements and were diagnosed as having ballismus-chorea associated with nonketotic hyperglycemia. While one of the patients was not diagnosed with diabetes mellitus, the other one did not administer insulin therapy for a long time which was prescribed. The patients were investigated by cranial imaging and biochemical tests. The symptoms improved in one of them within hours, however, it took days to improve for the other one. This clinical situation, which is thought to be caused by hyperglycemia, cerebral ischemia and failure of gamma-aminobutyric acid (GABA) and which probably improves with regulation of blood glucose levels, should be kept in mind by emergency physicians, because it can be the first presentation of type 2 diabetes mellitus.

Non-ketotik hipergliseminin nadir görülen bir komplikasyonu olan kore-ballismus, tip 2 diyabetin ilk bulgusu olarak ortaya çıkabilir. Burada istemsiz hareketler yakınması ile başvuran ve yapılan incelemeler sonrasında non-ketotik hiperglisemi ve bununla ilişkili kore-balismus tanısı alan 2 olgu bildirilmiştir. Hastalardan birisine ilk kez diyabet tanısı konulurken, diğer hastanın kullanması gereken insülin tedavisini uzun süredir almadığı öğrenilmiştir. Kranyal görüntülemeleri ve laboratuar incelemeleri ile değerlendirilen hastaların birinde saatler içinde, diğerinde ise günler içinde klinik Table nun gerilediği görülmüştür. Patogenezinde hiperglisemi, serebral iskemi ve gamma aminobütirik asitin (GABA) tükenmesinin rol oynadığı düşünülen ve kan şekeri regülasyonu ile genellikle düzelen bu klinik Table nun özellikle diyabeti bilinmeyen hastalarda acil servise ilk başvuru nedeni olabileceği hatırlanmalıdır.

Keywords: Ballismus; Chorea; Nonketotic hyperglycemia.

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Conflict of interest statement

Conflict of interest: The authors reported no conflict of interest related to this article. Çıkar çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir.

Figures

Figure 1
Figure 1
Hyperdense lesions in bilateral putamen and globus pallidum with predominance in the right (arrow) on non-contrast cranial CT
Figure 2
Figure 2
Marked bilateral hypointense appearance in the right putaminal region (arrow) on T2-weighted MR sections
See this image and copyright information in PMC

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