Non-ketotic hyperglycemic hemichorea

Case contributed by Dr Heba Abdelmonem

Presentation

Admitted with severe headache, confusion and disturbed conscious level. The patient gave history of involuntary movements the day before the onset of symptoms.

Patient Data

Age: 70 years
Gender: Female

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.

Case Discussion

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.

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Case information

rID: 63189
Published: 18th Sep 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Zagazig University Hospital

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