Keywords
Non-ketotic Hyperglycinemia, Hyperglycemia, Hemichorea, Hemiballismus, Dyskinesias, diabetic striatopathy, diabetes
Date of Presentation
5-1-2025 12:00 AM
Poster Abstract
Non-ketotic hyperglycemia hemichorea-hemiballismus (NH-HC), also known as diabetic striatopathy, is a rare condition characterized by glucose levels greater than 200 mg/dL and continuous, involuntary, and irregular large amplitude jerky movements localized predominantly to one side of the body called hemichorea-hemiballismus. While the differential diagnosis of irregular movements is vast, including seizures disorder, stroke, tumors, Tourette’s syndrome and rheumatic fever, clinicians should also consider diabetic striatopathy as a differential as it has very good prognosis and is easily treatable if diagnosed early. Here we discuss the case of a 72 year-old male with history of non-insulin dependent type 2 diabetes (T2DM), who presented to the emergency department awake, alert, and oriented complaining of intermittent left arm jerking and mild weakness x 3 days, who was subsequently found to have glucose of >1000 and HBA1C >14, was hospitalized, treated with insulin for 2 days with complete resolution of symptoms.
Disciplines
Emergency Medicine | Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Medicine and Health Sciences | Nutritional and Metabolic Diseases | Pathological Conditions, Signs and Symptoms
DOI
10.31986/issn.2689-0690_rdw.stratford_research_day.45_2025
Included in
Emergency Medicine Commons, Endocrine System Diseases Commons, Endocrinology, Diabetes, and Metabolism Commons, Nutritional and Metabolic Diseases Commons, Pathological Conditions, Signs and Symptoms Commons
Case Report: Non-Ketotic Hyperglycemia Hemichorea-Hemiballismus in the Emergency Department
Non-ketotic hyperglycemia hemichorea-hemiballismus (NH-HC), also known as diabetic striatopathy, is a rare condition characterized by glucose levels greater than 200 mg/dL and continuous, involuntary, and irregular large amplitude jerky movements localized predominantly to one side of the body called hemichorea-hemiballismus. While the differential diagnosis of irregular movements is vast, including seizures disorder, stroke, tumors, Tourette’s syndrome and rheumatic fever, clinicians should also consider diabetic striatopathy as a differential as it has very good prognosis and is easily treatable if diagnosed early. Here we discuss the case of a 72 year-old male with history of non-insulin dependent type 2 diabetes (T2DM), who presented to the emergency department awake, alert, and oriented complaining of intermittent left arm jerking and mild weakness x 3 days, who was subsequently found to have glucose of >1000 and HBA1C >14, was hospitalized, treated with insulin for 2 days with complete resolution of symptoms.