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Case Reports
. 2024 May 22;17(5):e259046.
doi: 10.1136/bcr-2023-259046.

Hemichorea-hemiballismus due to diabetic striatopathy a serious complication of uncontrolled diabetes

Brian Middleton  1 , Zhanna Albany  2 , Aaron Kamer  3 , Areeba Kara  4
Affiliations
Case Reports

Hemichorea-hemiballismus due to diabetic striatopathy a serious complication of uncontrolled diabetes

Brian Middleton et al. BMJ Case Rep. .

Abstract

We report the case of a man in his mid-80s with diabetes mellitus who presented to the emergency department with a 1-day history of right-sided choreiform movements and falls. Laboratory tests revealed blood glucose of 597 mg/dL. Non-contrast CT imaging of his head demonstrated a faint hyperdensity involving the left lentiform nucleus and brain MRI showed a hyperintensity in the left basal ganglia on T1-weighted images. These lesions are typical of diabetic striatopathy. Symptoms of hemichorea/hemiballismus did not resolve with glycaemic control and several pharmacological agents were tried with eventual improvement with risperidone. He was discharged to a rehabilitation facility and had mild persistent arm chorea at 6-month follow-up.

Keywords: Diabetes; Endocrine system; Movement disorders (other than Parkinsons); Neurology (drugs and medicines); Primary Care.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) CT of the head without intravenous contrast. Hyperdensity is present in the left caudate nucleus (long arrow) and left lentiform nucleus (short arrow). (B) Axial T1 MRI sequence. Hyperintensity is present in the left caudate (long arrow) and putamen, globus pallidus (short arrow).
See this image and copyright information in PMC

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