Session Information
Date: Monday, September 23, 2019
Session Title: Choreas (Non-Huntington’s Disease)
Session Time: 1:45pm-3:15pm
Location: Les Muses, Level 3
Objective: chorea is a rare complication of uncontrolled type 2 diabetes . we report a case of hyperglycemia, due to uncontrolled type 2 diabetes, presented by acute hemichorea.
Background: A 71 years old , female patient , diabetic 15 years ago (type2 , on oral hypoglycemic drugs yet not compliant nor controlled) , hypertensive , non smoker , presented by sudden onset , stationary course of one month duration of right sided involuntary, jerky, brief , semi- purposeful movement (hemi-chorea) involving both right upper limb and lower limb and facial grimace with intact conscious level. Her serum sugar was 417 mg/dl, with no acetone in urine . Her glycated hemoglobin was 12.4%, and other laboratory investigations were within normal.
Method: A computed tomography scan of the brain showed left basal ganglionic hyperdense lesion and her MRI brain showed left hyperintense lesion in T1 film and hypointense in T2star film. She controlled her diabetes and received Resperidone 4 mg and improved partially also her follow up CT brain showed regression of left basal ganglionic lesion.
Results: in this case patient had diabetic striatopathy which is a syndrome characterized by presence of increased signal with the corpus striatum on T1WI, with contralateral hyperkinetic movement disorders. Commonly observed in patients with type 2 DM. Most patients at time of presentation have a clinical picture consistent with non-ketotic hyperglycemia. Mechanisms of chorea in this case include relative dopaminergic hypersensitivity, vascular insuffiency causing transient ischemia to basal ganglia and shifting of cerebral metabolism to anaerobic pathway causing reduction in both GABA and acetylcholine with metabolic acidosis leading to basal ganglia dysfunction.
Conclusion: hemichorea is a rare complication of diabetes and this will direct the clinicians for optimum control of hyperglycemia.
To cite this abstract in AMA style:
M. Salem, A. Helmy, E. Abdeldayem, A. Shalash. Acute hemichorea in patient of uncontrolled type 2 diabetes mellitus; a case report with characteristic imaging [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/acute-hemichorea-in-patient-of-uncontrolled-type-2-diabetes-mellitus-a-case-report-with-characteristic-imaging/. Accessed June 14, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/acute-hemichorea-in-patient-of-uncontrolled-type-2-diabetes-mellitus-a-case-report-with-characteristic-imaging/