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Review
. 2020 May 29;99(22):e19801.
doi: 10.1097/MD.0000000000019801.

Clinical manifestation of non-ketotic hyperglycemia chorea: A case report and literature review

Weijing Wang  1 , Xiaomei Tang  1 , Hao Feng  1 , Fenghui Sun  1 , Lei Liu  1 , Gary B Rajah  2 , Fengchun Yu  1
Affiliations
Review

Clinical manifestation of non-ketotic hyperglycemia chorea: A case report and literature review

Weijing Wang et al. Medicine (Baltimore). .

Abstract

Introduction: Chorea is considered a special complication of diabetes mellitus. Here we report a case of chorea associated with non-ketotic hyperglycemia (NKH).

Patient concerns: The patient was a 79-year-old Asian woman. She had a history of type 2 diabetes mellitus more than 30 years, but with a poor control of blood sugar. She complained of acute onset of right limb involuntary activities, and being admitted to neurology department.

Diagnosis: The patient was then diagnosed with NKH chorea.

Interventions: Intravenous infusion of insulin was given to reduce blood glucose. Haloperidol was used to control motor symptoms.

Outcomes: Her symptoms improved quickly after treatment. In the past year, the patient's blood sugar was well controlled and her chorea did not recur.

Lessons: If there are sudden abnormal movements in patients, in addition to thinking of chorea, hepatolenticular degeneration and other diseases, we should also pay attention to blood sugar, especially in diabetic patients with poor blood sugar control and negative ketone, we should consider the possibility of NKK chorea.

Conclusions: NKH chorea is a special complication of diabetes.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Computed-tomography of her head was negative.
Figure 2
Figure 2
Brain magnetic resonance image (MRI) on the second day of the symptom: T1-MRI(2A), T2-MRI(2B), and DWI(2C) were normal, ADC(2D) showed low signals in the left basal ganglia, and high signals in E-ADC(2E) in the same part.
Figure 3
Figure 3
Brain magnetic resonance image after treatment: the low signals of ADC(3A) and E-ADC(3B) signal was improved than before.
See this image and copyright information in PMC

References

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