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
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.
