American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2020, 8(6), 159-161
DOI: 10.12691/ajmcr-8-6-6
Open AccessCase Report

Hemichorea-Hemiballismus as an Unusual Presentation of Hyperosmolar Hyperglycemic Syndrome

Javier Ticona1, Victoria Zaccone1, Unaiza Zaman1, Daniel Kashani1, Zachary Chung1 and Isabel M. McFarlane1,

1Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203 USA

Pub. Date: April 05, 2020

Cite this paper:
Javier Ticona, Victoria Zaccone, Unaiza Zaman, Daniel Kashani, Zachary Chung and Isabel M. McFarlane. Hemichorea-Hemiballismus as an Unusual Presentation of Hyperosmolar Hyperglycemic Syndrome. American Journal of Medical Case Reports. 2020; 8(6):159-161. doi: 10.12691/ajmcr-8-6-6


Diabetes mellitus can lead to a diverse array of systemic complications. Poorly managed hyperglycemia can result in serious neurological consequences ranging from peripheral neuropathy to seizures and coma. A rare neurologic disorder seen in acute decompensated type 2 diabetes mellitus (T2DM) is hemichorea-hemiballismus (HCHB). HCHB is a movement disorder primarily associated with cerebrovascular accidents of infarct or hemorrhagic origin. It is a condition that can occur in a diabetic patient, especially when no other signs or symptoms of hyperglycemia are present. It is urgent to recognize HCHB movement disorder quickly as it may be the only presenting sign of hyperglycemia and can alert medical personnel to a possible hyperosmolar hyperglycemic state (HHS). We report an unusual case of HCHB in a patient with HHS, whose only presenting sign was unilateral hyperkinesis, which completely resolved after adequate blood glucose control. Prompt treatment and management of hyperglycemia yields an excellent prognosis in HCHB.

type 2 diabetes mellitus movement disorders chorea hemiballismus hyperosmolar hyperglycemic syndrome basal ganglia

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