Left Lower Arm Hemichorea: An Unusual Presentation of New-Onset Type 2 Diabetes.

Abstract

Diabetes mellitus is a growing public health concern and a chronic metabolic disease worldwide. The most common clinical manifestations at the onset of diabetes are blurry vision, weight loss, polyuria, polydipsia, and polyphagia. Neurological symptoms are rare but have been reported to be associated with initial presentation of type 2 diabetes, especially hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Hemichorea-hemiballism (HCHB) is a spectrum of involuntary, continuous, nonpatterned movements involving one side of the body that is usually caused by a variety of hereditary neurological diseases, metabolic disorders, post-rheumatic fever sequelae, strokes, and other vascular diseases. Herein, we report the case of a man with left-side arm hemichorea (HC) who presented with HHNS and had resolution of his symptoms when his blood glucose was back under control. This case report highlights the association between HC and HHNS and reinforces the need to recognize HHNS promptly, especially in elderly patients who present with a neurological complaint. A 72-year-old Caucasian man presented with a 2-week history of progressive writhing movements of his left arm, with occasional sudden amplitude excursions, associated …