A rare case of recurrent biballism

Abstract

Diabetic striatopathy (DS) is a relatively new entity with growing literature expanding our knowledge of the same. It is commonly seen in elderly Asian females with long-term uncontrolled type 2 diabetes mellitus presenting with hemichorea or hemiballism with characteristic reversible imaging findings involving various basal ganglia structures. While various different types of presentations with variable responses to therapy in terms of treatment modality and recovery time have been reported, there is very little data on the recurrence of this entity. We, hereby, present an interesting case of DS, which had a rare presentation in the form of biballism. Our patient had an initial swift recovery with glycemic control alone and thereafter a ropinirole-induced recurrence in spite of good glycemic control, which was rather difficult to control. This case emphasizes the need for clinicians to be aware of the various presentations of DS and to be cautious in the use of drugs with the potential to cause movement disorders in such a patient.