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Chorea-ballismus in acute non-ketotic hyperglycaemia.

Abstract
Diabetic patients during hyperglycaemic crises may present a rare syndrome characterised by a typical triad: unilateral involuntary movements (hemichoreahemiballism), radiological contralateral striatal abnormality, and rapid resolution of symptoms after glycae - mic correction. This study reports a series of patients showing less usual aspects and also discusses the pathophysiology of this clinical-radiological syndrome. We included in this study four patients presenting choreic or ballic involuntary movements and in whom aetiological assessment revealed frank non-ketotic hyperglycaemia, without other abnormalities that could explain the movement disorder. All the patients underwent CT or MR brain imaging. The typical triad was present in only one case. Less classical aspects were more frequently found: movement disorders revealed diabetes in two patients and one patient had generalised chorea and strictly normal neuroimaging. Correction of blood glucose was not sufficient to improve symptoms in two cases. In one, abnormal movements persisted despite treatment with tetrabenazine. The clinical, radiological and outcome spectrum of the syndrome of chorea-ballismus induced by non-ketotic hyperglycaemia is heterogeneous and not restricted to a typical triad.
AuthorsH El Otmani, F Moutaouakil, H Fadel, N El Ouafi, M Abdoh Rafai, B El Moutaouakil, I Slassi
JournalFunctional neurology (Funct Neurol) 2009 Jul-Sep Vol. 24 Issue 3 Pg. 129-32 ISSN: 0393-5264 [Print] Italy
PMID20018139 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Blood Glucose
Topics
  • Aged
  • Blood Glucose (metabolism)
  • Brain Diseases (blood, pathology)
  • Chorea (blood, diagnosis, etiology, pathology)
  • Diabetes Complications (blood, pathology)
  • Diabetes Mellitus (blood, pathology)
  • Female
  • Functional Laterality
  • Humans
  • Hyperglycemia (blood, pathology)
  • Ketosis (blood, pathology)
  • Male
  • Middle Aged
  • Neostriatum (pathology)

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