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Hyperglycaemic Hemichorea

BACKGROUND: Hyperkinetic disorders such as hemichorea can be caused by cerebrovascular, infectious or inflammatory diseases or by metabolic conditions such as hyperglycaemia. Hyperglycaemic hemichorea is a rare movement disorder which is frequently misdiagnosed. It is characterized by involuntary, c...

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Autores principales: Marques, Joana Silva, Monteiro, Nuno, Nunes, Ana, Machado, João, Olivério, João, Martins, Ana Sofia, Correia, António
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SMC Media Srl 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346758/
https://www.ncbi.nlm.nih.gov/pubmed/30756023
http://dx.doi.org/10.12890/2018_000807
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author Marques, Joana Silva
Monteiro, Nuno
Nunes, Ana
Machado, João
Olivério, João
Martins, Ana Sofia
Correia, António
author_facet Marques, Joana Silva
Monteiro, Nuno
Nunes, Ana
Machado, João
Olivério, João
Martins, Ana Sofia
Correia, António
author_sort Marques, Joana Silva
collection PubMed
description BACKGROUND: Hyperkinetic disorders such as hemichorea can be caused by cerebrovascular, infectious or inflammatory diseases or by metabolic conditions such as hyperglycaemia. Hyperglycaemic hemichorea is a rare movement disorder which is frequently misdiagnosed. It is characterized by involuntary, continuous, non-patterned movements on one side of the body, basal ganglia lesions seen on head CT or MRI, and clinical improvement after blood glucose normalization. We describe the case of a female patient with uncontrolled diabetes who presented with hemichorea. CASE PRESENTATION: We report the case of a 69-year-old woman with type 2 diabetes who presented with abnormal movements of the right upper limb. She had no neurological signs other than hemichorea. Her blood glucose level was 349 mg/dl and her glycosylated haemoglobin level (HbA1c) was 10.5%. Head CT and MRI showed no changes in the basal ganglia or ischaemic lesions. The patient was started on insulin and haloperidol with clinical improvement. CONCLUSION: Larger case series are needed to establish better understanding of the physiopathological mechanisms and diagnostic criteria of hyperglycaemic hemichorea. The most important diagnostic criterion is clinical improvement after glycaemic control. LEARNING POINTS: Hyperglycaemia is a rare cause of hemichorea. Better understanding of the physiopathology and the establishment of diagnostic criteria are required. Correction of the underlying hyperglycaemia will lead to rapid improvement of the movements and is the most important feature for diagnosis.
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spelling pubmed-63467582019-02-12 Hyperglycaemic Hemichorea Marques, Joana Silva Monteiro, Nuno Nunes, Ana Machado, João Olivério, João Martins, Ana Sofia Correia, António Eur J Case Rep Intern Med Articles BACKGROUND: Hyperkinetic disorders such as hemichorea can be caused by cerebrovascular, infectious or inflammatory diseases or by metabolic conditions such as hyperglycaemia. Hyperglycaemic hemichorea is a rare movement disorder which is frequently misdiagnosed. It is characterized by involuntary, continuous, non-patterned movements on one side of the body, basal ganglia lesions seen on head CT or MRI, and clinical improvement after blood glucose normalization. We describe the case of a female patient with uncontrolled diabetes who presented with hemichorea. CASE PRESENTATION: We report the case of a 69-year-old woman with type 2 diabetes who presented with abnormal movements of the right upper limb. She had no neurological signs other than hemichorea. Her blood glucose level was 349 mg/dl and her glycosylated haemoglobin level (HbA1c) was 10.5%. Head CT and MRI showed no changes in the basal ganglia or ischaemic lesions. The patient was started on insulin and haloperidol with clinical improvement. CONCLUSION: Larger case series are needed to establish better understanding of the physiopathological mechanisms and diagnostic criteria of hyperglycaemic hemichorea. The most important diagnostic criterion is clinical improvement after glycaemic control. LEARNING POINTS: Hyperglycaemia is a rare cause of hemichorea. Better understanding of the physiopathology and the establishment of diagnostic criteria are required. Correction of the underlying hyperglycaemia will lead to rapid improvement of the movements and is the most important feature for diagnosis. SMC Media Srl 2018-04-24 /pmc/articles/PMC6346758/ /pubmed/30756023 http://dx.doi.org/10.12890/2018_000807 Text en © EFIM 2018 This article is licensed under a Commons Attribution Non-Commercial 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Articles
Marques, Joana Silva
Monteiro, Nuno
Nunes, Ana
Machado, João
Olivério, João
Martins, Ana Sofia
Correia, António
Hyperglycaemic Hemichorea
title Hyperglycaemic Hemichorea
title_full Hyperglycaemic Hemichorea
title_fullStr Hyperglycaemic Hemichorea
title_full_unstemmed Hyperglycaemic Hemichorea
title_short Hyperglycaemic Hemichorea
title_sort hyperglycaemic hemichorea
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346758/
https://www.ncbi.nlm.nih.gov/pubmed/30756023
http://dx.doi.org/10.12890/2018_000807
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