The Dance-de-Diabetes A Rare Complication of Non Ketotic Hyperglycemia

Abstract

Diabetes mellitus, its diagnosis, and treatment along with the management of complications particularly Diabetic Ketoacidosis and the ominous Hyperglycemic osmolar Non-Ketotic Coma are well acquainted with all Physicians and Internists. Hemiballismus is an aberrant movement disorder that is characterized by uncontrolled, random, large-amplitude movements of the limbs. It is usually caused by a vascular lesion that involves the contralateral subthalamic nucleus (STN).The authors present a case of Diabetes mellitus presenting de Novo with Non-Ketotic Hyperglycemia manifesting with hemiballismus. Their brain CT scan pictures showed non-enhancing hyperdensities in the contralateral basal ganglia, and the MRI showed hyperintensities on T1W image and hypo-intensities on the T2W image. The patient was managed with aggressive glycemic control with insulin infusion along with Dopamine ( D2 ) Receptor antagonist Tetrabenazine. This case illustrates the importance of considering movement disorders in the differential diagnosis of hyperglycemic emergencies and distinguishing it from other intracranial pathologies as prompt diagnosis and treatment of hyperglycemia has a favorable prognosis.