Objective: To describe an elderly patient with the rare manifestation of hyperglycemia in new onset diabetes mellitus.

Background: The most common cause of new-onset hemibody hyperkinesia among elderly patients are due to vascular causes. Hemiballismus is rarely associated with diabetes mellitus. We report a case of an elderly patient which patient’s manifestation of hyperglycemia was the unusual movement disorder.

Methods: Case Report.

Results: We present a case of a 65 years old woman who presented with large amplitude jerking and exhausting movement in left arm and leg for seven days. These movements occurred spontaneously and interfered with her activity. The neurologic examination revealed normal motor tone and strength. Deep tendon reflexes were increasing in left extremity, and pathological reflexes were negative. The others neurologic examination were unremarkable. Initial blood glucose level was 570 mg/dl (in primary care). HBA1c level was 12,3. The brain non contrast computed tomography (NCCT) at admission revealed hyperdensity affecting right lentiform nucleus. The patient was started on intravenous fluid, insulin and received haloperidol and clonazepam. Patients showing complete resolution of involuntary movements within a day of correction of hyperglycemia as the glucose blood level reached 170 mg/dl. [figure1]

Conclusions: Hemiballismus as the single manifestation of hyperglycemia in elderly is a rare condition. Rapid correction of blood glucose level is the main management of movement disorders induced by hyperglycemia.

References: 1. S Morales-Vidal, N Kartha, R M Dafer, M J Schneck, J Biller. Cerebrovascular disease and movement disorder in Uncommon Causes of Movement Disorders. Cambridge University Press. New York: 2011. 2. W Z Alkilani, H Tahir, N Gibb, S Ullah, N M Vinod. Hyperglycemia Induced Reversible Hemiballismus as the Main Presentation of Newly Diagnosed Diabetes Mellitus. American Journal of Medical Case Report. 2016, (7): 245-247.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/hemiballismus-as-single-manifestation-of-nonketotic-hyperglycemia-in-elderly/