Non-ketotic hyperglycemic hemichorea

Case contributed by Dr Franco A. Scola

Presentation

Agitation and decreased consciousness

Patient Data

Age: 65
Gender: Female

Circunscribed hyperdense right striatal region without mass effect or surrounding edema.

Hypodense focci seen on left basal ganglia and deep white matter bilateraly.

At the right striatal region there is a T1WI high signal, T2WI and FLAIR low signal and retricted difussion at DWI. No repercussion at T2GRE sequence.

Lacunaire infarcts on left basal ganglia and deep white matter and some focci of microangyopathy.

At control CT, acquired 45 days after previous CT and 38 days after the MRI study, there was an important reduction in the striatal region density.

Case Discussion

The patient had already been diagnosed with type 2 diabetes, and at the time of presentation on the ER was hyperglycemic.

Non-ketotic hyperglycemic hemichorea is rare disorder, but in most cases a reversible complication of nonketotic hyperglycemia, with a characteristic high signal at T1WI in the striatal region, sparing the thalamus.

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Case information

rID: 57454
Published: 12th Jun 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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