Hemichorea Secondary to Non-Ketotic Hyperglycemia as the Presenting Manifestation of Diabetes Mellitus

Nonketotic hyperglycemia is an unusual and rare cause of hemichorea. Hemichorea though rare may be the initial manifestation of diabetes mellitus. Correction of the hyperglycemia usually results in total resolution of the signs and symptoms. We present the case of a 71 yr old female, who presented with subacute onset of choreiform movement of left upper and lower extremities over 8 days. Her serum glucose level was 416 mg/dl and urine ketone bodies were absent. Computed tomography of brain showed right caudate nucleus and right lentiform nucleus hyperdensity suggesting hyperglycemia related hemichorea syndrome. Restoration of euglycemia along with treatment with haloperidol and tetrabenazine led to eventual resolution of all symptoms. So, nonketotic hyperglycemia should be kept as a differential diagnosis in a patient with hemichorea.