HEMICHOREA ASSOCIATED WITH NON-KETOTIC HYPERGLICEMIA: REPORT OF TWO CASES AND BRIEF REVIEW OF THE LITERATURE

Abstract

Introduction: Chorea is characterized as a hyperkinetic movement disorder that is caused by lesions on the basal ganglia. Many etiological factors have been described, including ischemia, infection, neoplasm and neurodegenerative disorders, such as Hun-tington’s disease. Non-ketotic hyperglycemia induced chorea is a rare, but reversible, condition usually associated with contralat-eral striatal radiological abnormalities. Case Report: Case 1: A 64 year-old Brazilian woman was admitted concerning about a 4-day history of involuntary, erratic and continuous movements with sudden onset affecting the left arm, leg and, partially, the left hemiface. Her past medical history was remarkable for arterial hypertension and type 2 diabetes mellitus. Neurologic examina-tion revealed the presence of choreic movements of the left hemiface, arm and leg. Case 2: A 63 year-old Brazilian woman was admitted concerning about an 1-day history of involuntary, without purpose, assymmetric, irregular and abrupt movements of the upper limbs and face associated with difficulty of speaking and swallowing. Her past medical history was remarkable for arterial hypertension and coronariopathy with two episodes of acute myocardial infarction four months before. There was no history of diabetes mellitus. On neurological examination, she presented severe dysartry and difficulty of swallowing associated with choreic movements of the upper limbs and face. Conclusion: In the present study, we describe two cases of chorea as a complication of non-ketotic hyperglycemia. A high index of clinical awareness and early suspicion of this possible association are extremely important, once the correct management and normalization of glycemia may result in complete recovery of neurologic symptoms.