Category: Rare Genetic and Metabolic Diseases
Objective: To investigate the clinical spectrum and implications of movement disorders (MD) in patients presenting with de novo hyperglycemic crisis (DNHC).
Background: DNHC, characterized by severe hyperglycemia without a prior diabetes diagnosis, poses management challenges. When accompanied by MD, understanding the spectrum and implications becomes essential for timely diagnosis and management.
Method: A retrospective case series analysis was conducted on 273 patients who presented with DNHC at the emergency department of a tertiary hospital. A subset of patients who presented with MD during hospitalization was selected for detailed analysis. Clinical data, encompassing symptoms, laboratory findings, comorbidities, and discharge conditions, was recorded.
Results: Among 13 patients (≈5% of the cohort), with a mean age of 64.5 years and 53.8% male, average glycemia was 429 mg/dL. MD included fine tremor (38.5%), truncal ataxia (23.1%), generalized myoclonus (15.4%), upper extremities myoclonus (15.4%), and chorea (7.7%). Prevalent comorbidities included hypertension (84.6%), schizophrenia, hypothyroidism, and obesity (7.7% each). Abnormal urea levels were found in 53.9% of cases, while abnormal creatinine levels were observed in 30.8%. Notably, one patient with chorea had basal ganglia calcification on a CT scan. Mortality stood at 7.7%. Symptom duration ranged from 18 to 72 hours, though not all cases reported this information.
Conclusion: The presence of MD emphasizes their significance as valuable clinical indicators for identifying de novo hyperglycemic crises, emphasizing the necessity for heightened awareness among healthcare professionals, especially in emergency settings. Timely identification and effective management of hyperglycemic crises, particularly when accompanied by movement disorders, are imperative for enhancing patient outcomes.
To cite this abstract in AMA style:
D. Japón-Cueva, C. Rodriguez-Alarcon, A. Carofilis-Cornejo, L. Viñan-Paucar, M. Cueva-Espinoza, P. Gruezo-Realpe, D. Ocampo, R. Santibanez-Vasquez. Movement Disorders in De Novo Hyperglycemic Crisis: Insights from a Clinical Case Series [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/movement-disorders-in-de-novo-hyperglycemic-crisis-insights-from-a-clinical-case-series/. Accessed June 14, 2025.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/movement-disorders-in-de-novo-hyperglycemic-crisis-insights-from-a-clinical-case-series/