title: Hemichorea/Hemiballism Associated with Hyperglycemia: Report of 20 Cases.
abstract: BACKGROUND
  Hemichorea/hemiballism associated with nonketotic hyperglycemia is a well-recognized syndrome, but few case series have been reported in the literature.
  
  
  METHODS
  We describe 20 patients with hemichorea/hemiballism associated with hyperglycemia (9 males and 11 females) with mean age of 67.8 years. Ten patients had a previous diagnosis of type 2 diabetes mellitus, and one had type 1 diabetes mellitus. Six of them had documentation of poor diabetic control over at least the last 3 months. Nine patients had new-onset hyperglycemia with a diagnosis of diabetes mellitus made after discharge. Seventeen patients had unilateral chorea/ballism, while three had bilateral chorea/ballism. Eighteen cases had striatal hyperdensities on computed tomography (CT) and/or hyperintense signals on magnetic resonance imaging (MRI). The putamen was affected in all cases, and the caudate nucleus was involved in nine.
  
  
  CONCLUSIONS
  Hemichorea/hemiballism associated with nonketotic hyperglycemia can be the presenting sign of diabetes mellitus in almost half of cases or can occur after a few months of poor glycemic control in patients with diagnosed diabetes. This case series is one of the largest to date and adds valuable information about clinical and neuroimaging features that are comparable with published data but also emphasize the role of adequate diabetes mellitus control.
authors.affiliation: Departamento de Enfermedades Neurodegenerativas, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Carlos
authors.initials: C
authors.lastname: Cosentino
authors.affiliation: Departamento de Enfermedades Neurodegenerativas, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Luis
authors.initials: L
authors.lastname: Torres
authors.affiliation: Departamento de Enfermedades Neurodegenerativas, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Yesenia
authors.initials: Y
authors.lastname: Nuñez
authors.affiliation: Departamento de Enfermedades Neurodegenerativas, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Rafael
authors.initials: R
authors.lastname: Suarez
authors.affiliation: Departamento de Enfermedades Neurodegenerativas, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Miriam
authors.initials: M
authors.lastname: Velez
authors.affiliation: Departamento de Enfermedades Neurodegenerativas, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Martha
authors.initials: M
authors.lastname: Flores
keywords: Chorea; ballism; hyperglycemia