Chorea Associated with Nonketotic Hyperglycemia: A Case Report

Abstract

Shaoyun Wang, Cheryl Wang

A 79 years old Chinese man presented with 2 episodes of unilateral chorea of left limb (with a short period of bilateral). MRI performed after the onset of the first episode showed multiple old infarctions at bilateral basal ganglia). The first episode lasted about 3 weeks, was resolved after blood glucose better controlled. About 1 week later, he had the second episode. MRI showed high signal intensity on T1-weighted images, low signal intensity on T2-weighted images. This episode was resolved in about 1 week with better glucose control and haloperidol. It suggested that there may be an association of chorea and changes of basal ganglia. So far, there are very limited reports on chorea associated with nonketotic hyperglycemia, only few hundreds of cases reported. It affects elderly type 2 diabetics, is reported more common in Asians. It can be unilateral or bilateral. The pathogenesis remains unclear. Changes of basal ganglia and putamen seems be contributing.

PDF