title: Hemichorea associated with nonketotic hyperglycemia: clinical and neuroimaging features in 12 patients.
abstract: BACKGROUND
  Nonketotic hyperglycemia is a rare cause of hemichorea. Patients with hemichorea associated with nonketotic hyperglycemia (HCNH) always have a favorable prognosis when given prompt treatment.
  
  
  METHODS
  We reviewed the medical records of 12 patients with HCNH in our hospital between January 2005 and January 2013. The clinical data, laboratory findings, and imaging features of the patients were collected.
  
  
  RESULTS
  All 12 patients were admitted to the hospital with a complaint of involuntary movements. Ten patients had a history of diabetes, while the other 2 patients had not been diagnosed. The mean level of blood glucose on admission was 330.7 ± 107.8 mg/dl, and the ketones were negative. A cranial computed tomography scan showed hyperdensity in the striatum, which quickly resolved. Magnetic resonance imaging showed hyperintensity on T1-weighted images without change over several months. Nearly all of the patients experienced relief from the hemichorea symptoms after correcting hyperglycemia with a combination of dopamine receptor inhibitors and the sedative lorazepam, if necessary.
  
  
  CONCLUSIONS
  HCNH is a benign disorder, the pathogenesis of which remains unclear. Radiologic changes can provide guidance for early treatment and generally give an estimation of the degree of injury.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Guo
authors.forename: Yan-Wei
authors.initials: YW
authors.lastname: Miao
authors.forename: Xiao-Fei
authors.initials: XF
authors.lastname: Ji
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.forename: Xuan
authors.initials: X
authors.lastname: Liu
authors.forename: Xiao-Pei
authors.initials: XP
authors.lastname: Sun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000473:pathology; D002819:Chorea / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology*; D018492:Dopamine Antagonists / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology*; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007659:Ketones / Q000097:blood; D008140:Lorazepam / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D018492:Dopamine Antagonists; D006993:Hypnotics and Sedatives; D007659:Ketones; D008140:Lorazepam