Abnormal movements like hemichorea are rarely described as neurological manifestations of hyperglycemia. It is occur in nonketotic hyperglycemia with a pathognomonic radiological findings. We report a case of a 70 years old women with no past medical history who presented to the emergency department with abnormal limb movements. It was repetitive, brief, involuntary movement of the right arm evolving for 5 days. On admission, neurological examination showed right hemichorea. She did not demonstrate any other neurologic deficit, such as hemiparesis or sensory change. Blood glucose level was 3.47 g/l and ketone bodies were not detected in the urine. Full blood count, liver function tests, renal function tests, inflammatory markers, thyroid function tests and electrocardiogram were normal. The CT scan showed unilateral spontaneous hyperdensity of the left lenticular nucleus. The patient was started on insulin. Evolution was marked by the gradual decrease of chorea until complete disappearance after one week. In conclusion Hemichorea is a rare manifestation of nonketotic hyperglycemia. Recognition of this clinicoradiologic syndrome is important because correction of hyperglycemia lead to neurological improvement.
18 - 21 May 2019
European Society of Endocrinology