Abstract
<strong>Background:</strong> Hypo/hyperglycemia is a known cause of chorea and hemiballism. The temporallobes, hippocampus, basal ganglia, and substantia nigra are most susceptible to hypoglycemic changes. <strong>Methods:</strong> We present a caseof bilateral chorea and bi-ballism accompanied by encephalopathyin the setting of severe hypoglycemia and diabetic ketoacidosis. The patient had brain MRI changes involving both caudate nuclei, temporal lobes, and hippocampi. <strong>Discussion:</strong> This case demonstrates the basal ganglia’s vulnerability to hypoglycemia and the need for cautious evaluation of involuntary movements when they occur in the setting of encephalopathy.
Highlights
We present a case of bilateral chorea and ballism accompanied by encephalopathy in a patient with severe hypoglycemia and diabetic ketoacidosis
There have been case reports of chorea and hemiballism associated with hypo/hyperglycemia,[1,2,3] the findings in this case manifested bilaterally and were associated with brain magnetic resonance imaging (MRI) changes involving both right and left caudate nuclei, temporal lobes, and hippocampi
The temporal lobes, hippocampus, basal ganglia, and substantia nigra appear most susceptible.[4]. This case emphasizes the sensitivity of the basal ganglia to hypoglycemia, and the need for careful and thoughtful evaluation of involuntary movements when they co-occur with encephalopathy
Summary
Encephalopathy, Hypoglycemia, and Flailing Extremities: A Case of Bilateral Chorea–Ballism Associated with Diabetic Ketoacidosis. McFarland1* 1 University of Florida, Department of Neurology, Center for Movement Disorders & Neurorestoration, Gainesville, Florida, United States of America
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