A Case Report of Diabetic Striatopathy: Rare Section and Unusual Complication of Hyperglycaemia

Abstract

Non-Ketotic Hyperglycaemic (NKH) Hemichorea-Hemiballismus Syndrome/Diabetic Striatopathy (DS) is a rare neurological complication of diabetes mellitus. Hemichorea can present as a manifestation of diabetes mellitus or occur in patients with poorly controlled diabetes. This case report highlights the importance of differentiating this syndrome from other intracranial pathologies, as adequate glycaemic control can lead to complete resolution of the symptoms. The authors present a case of a 65-year-old female who presented to the Emergency Department (ED) with a sudden onset of involuntary movements in the left upper and lower limbs for 30 minutes. The patient was conscious and oriented, with a General Random Blood Sugar (GRBS) of 502 mg/dL, and ketone levels of 0.1 mmol/L (normal value: less than 0.6 mmol/L). The Computed Tomography (CT) scan revealed high attenuation in the right basal ganglia, and the Magnetic Resonance Imaging (MRI) of the brain indicated T1 hyperintensity in the right basal ganglia. The patient was managed with insulin infusion and hydration. Involuntary movements completely resolved after blood sugar levels were controlled with insulin. Hyperglycaemia should be considered as a differential diagnosis in patients presenting to the ED with hemichorea.

Keywords

• hemichorea
• hyperintense basal ganglia
• non ketotic hyperglycaemia