Hyperglycemic Hemichorea: A Case Series

Abstract

Hemichorea has been reported in subjects with hyperglycemia and the recurrent was rarely reported. We identified clinical presentation and course of hypeglycemic hemichorea in six cases, one of whom experienced recurrence. Mean age was 77.2 years and five were women. Duration of diabetes was 1-35 years. Initial HbA1c levels were 9.3%-13% and most patients had poor compliance. Five patients undertook brain magnetic resonance imaging and high signal intensities of basal ganglia was observed in T1-weighted images. All patients were treated with insulin, and four patients were treated with dopamine-receptor blockers. Mean duration of hemichorea was 69 days. One patient's hemichorea was recurred after 2 months from the time when the first event was resolved and then finally diagnosed with vasculitis. The prognosis of hyperglycaemic hemichoerea seemed to be good. However, we should consider other cause such as vasculitis when the symptom was recurred after adequate glycaemic control.

Keywords: Aged; Case reports; Chorea; Diabetes mellitus.

Fig. 1.

Findings of brain magnetic resonance imaging and brain ¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET) at the first event in Patient no# 2. (A) High signal intensities in the bilateral basal ganglia on T1-weighted imaging. (B) Low signal intensities in the bilateral basal ganglia on T2-weighted imaging. (C) Brain ¹⁸F-FDG PET image showing hypometabolism in the bilateral ganglia, especially in the putamen.