Non-ketotic hyperglycemic hemichorea
Admitted with severe headache, confusion and disturbed conscious level. The patient gave history of involuntary movements the day before the onset of symptoms.
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Abnormal increased T1 signal of the right basal ganglia. No abnormal signal changes in the basal ganglia on T2/FLAIR sequences or on DWI (not shown). Age-related cerebral volume loss with multiple abnormal T2/FLAIR white matter signal corresponds to small vessel ischemia.
CT of the brain (not shown) demonstrated increased density of the right basal ganglia.
This patient had uncontrolled diabetes with blood glucose level at the time of the study 400 mg/dl. Abnormal increased T1 signal of the basal ganglia has many causes, in this patient with uncontrolled blood sugar level, non-ketotic hyperglycemic hemichorea is the most likely.