Clinical features of hemichorea associated with non-ketotic hyperglycemia and literature review

doi:10.3877/cma.j.issn.2095-655X.2022.01.006

Abstract

Abstract:

Objective

To investigate the diagnostic features of hemichorea associated with non-ketotic hyperglycemia (HC-NH).

Methods

The clinical data of a patient with HC-NH admitted to the Neurology Department of Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University on December 8, 2019 was retrospectively analyzed, and relevant literatures were reviewed.

Results

A 51-year-old female patient was admitted to the hospital for dry mouth and polydipsia for more than 4 months, and involuntary movement of the right limb for 1 week. The clinical manifestations were hemichorea-like movements, increased blood sugar, and positive blood ketones. Brain CT showed the abnormally higher density shadow of the left lenticular nucleus. Brain MRI T₁WI showed abnormally high signal in the left basal ganglia region, T₂WI, fluid attenuated inversion recovery sequence (FLAIR) and diffusion weighted imaging (DWI) showed slightly low signal changes. The patient was diagnosed with HC-NH, and the blood glucose was actively controlled. After treatment with tiapride hydrochloride and diazepam, the patient′s chorea-like symptoms disappeared 1 month later. Brain CT reexamination showed normal and the condition was stable without recurrence so far.

Conclusion

Chorea-like symptoms, high blood sugar, positive blood ketones, abnormal signal in the basal ganglia region in brain CT or MRI, are important diagnostic features of HC-NH.

Key words: Chorea, Non-ketotic, Hyperglycemia, Basal ganglia

Hui Yu, Weixia Yang. Clinical features of hemichorea associated with non-ketotic hyperglycemia and literature review[J]. Chinese Journal of Diagnostics(Electronic Edition), 2022, 10(01): 26-30.

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References 20

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