Chorea induced by non-ketotic hyperglycaemia: a case report.
We describe an 81-year-old woman presenting with sudden onset of generalised chorea. She was unaware of suffering from diabetes. Laboratory screening revealed non-ketotic hyperglycaemia. Brain magnetic resonance imaging (MRI) failed to show basal ganglia abnormalities. Monotherapy with subcutaneous regular insulin induced a progressive normalisation of glycaemia as well as a parallel improvement of the abnormal involuntary movement scale on a nine-day sequential observation. This correlation strongly supports the hypothesis that non-ketotic hyperglycaemia itself might play a major pathogenetic role in chorea associated with non-ketotic hyperglycaemia. Diabetes mellitus should be suspected in patients who develop sudden onset of chorea even in the absence of putaminal abnormalities on MRI.
Branca
D
D
Neurologic Unit, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Via Melacrino, Reggio Calabria, Italy.
Gervasio
O
O
Le Piane
E
E
Russo
C
C
Aguglia
U
U
D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000473:pathology; D002819:Chorea / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D020158:Hyperglycinemia, Nonketotic / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging
D001786:Blood Glucose