Hemichorea Induced by Non-ketotic Hyperglycemia in a Caucasian Woman

Chorea is a disorder characterized by irregular, involuntary, hyperkinetic movements and has various causes. One unusual cause is hyperglycemia. This case involves a 76-year-old diabetic Caucasian female who developed gait disturbances, hemichorea of the face and limbs, and slurred speech over two to three weeks. She was found to have glucose level of 690 mg/dL with HbA1c of 14.7%. Head CT demonstrated hyperdensity in the left basal ganglia and mild involvement of right basal ganglia. Treatment with insulin alleviated her symptoms. The exact pathophysiology is unknown; however, many theories exist.