title: Encephalopathy, hypoglycemia, and flailing extremities: a case of bilateral chorea-ballism associated with diabetic ketoacidosis.
abstract: BACKGROUND
  Hypo/hyperglycemia is a known cause of chorea and hemiballism. The temporallobes, hippocampus, basal ganglia, and substantia nigra are most susceptible to hypoglycemic changes.
  
  
  METHODS
  We present a caseof bilateral chorea and bi-ballism accompanied by encephalopathyin the setting of severe hypoglycemia and diabetic ketoacidosis. The patient had brain MRI changes involving both caudate nuclei, temporal lobes, and hippocampi.
  
  
  CONCLUSIONS
  This case demonstrates the basal ganglia's vulnerability to hypoglycemia and the need for cautious evaluation of involuntary movements when they occur in the setting of encephalopathy.
authors: University of Florida, Department of Neurology, Center for Movement Disorders & Neurorestoration, Gainesville, Florida, United States of America.
authors: Waldo R
authors: WR
authors: Guerrero
authors: Michael S
authors: MS
authors: Okun
authors: Nikolaus R
authors: NR
authors: McFarland
keywords: Encephalopathy; ballism; chorea; diabetic ketoacidosis; hyperglycemia; hypoglycemia