Journal Mobile

YN Demssie, K Kaushal
Journal Issue: 
Volume 38: Issue 3: 2008




Hemichorea-hemiballismus (HC-HB) is a unilateral, involuntary, random movement disorder that can involve both proximal and distal groups of muscles. It  is  caused  by  lesions  in  the  contralateral  corpus  striatum. The  most  common aetiology  is  an  acute  cerebrovascular  event,  but  infections,  drugs,  tumours  and neurodegenerative  disorders  can  all  be  implicated.  Non-ketotic  hyperglycaemia has been identified as a metabolic cause of HC-HB, particularly in elderly female patients with newly diagnosed or poorly controlled diabetes. These patients tend to  have  a  characteristic  hyperintense  signal  in  the  putamen  on T1-weighted  MR imaging.  Often  the  movement  disorder  resolves  within  days  to  weeks  after correction of the hyperglycaemia, but complete resolution of the radiological signs commonly  takes  months.  An  86-year-old  woman  with  newly  diagnosed  type-2 diabetes  presented  with  hyperglycaemia-induced  right-sided  HC-HB  and  typical contralateral high signal change in the putamen on T1-weighted MR scanning. Her symptoms completely resolved within five days of achieving euglycaemia.