Anesthetic management of a patient with chorea hyperglycemia basal ganglia syndrome planned for above knee amputation

Abstract

Abstract Background Chorea hyperglycemia basal ganglia syndrome is a rare disorder causing involuntary movements in both upper and lower limbs. Uncontrolled hyperglycemia causes neurotransmitter derangements in basal ganglia resulting in involuntary movements. These cases pose different challenges to anaesthesiologist in both general and regional anaesthesia. Case presentation Here, we discuss a case of chorea hyperglycemia basal ganglia syndrome with lower limb gangrene posted for knee amputation done under spinal anaesthesia. Our patient had recurrent choreiform movements due to non-compliance to diabetic medications. Strict glycemic control always aids in reduction of choreiform movements along with improved wound healing. Conclusions Tight glycemic control and good anesthetic plan in perioperative period can reduce morbidity in patients affected with chorea hyperglycemia basal ganglia syndrome.

Keywords

• Hemichorea
• Regional anesthesia
• Hyperglycemia
• Basal ganglia hyperintensity