Chorea as a rare neurological complication of hyperglycaemia

Catarina Lizardo Cruz; Rita Mendes; Margarida Quinto Pereira; Vikesch Rameschandre Samji; Sérgio Pereira; Francisco  Silva; Isabel  Madruga

doi:10.5455/IJMRCR.172-1671017763

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Case Report

Int J Med Rev Case Rep. 2023; 7(2):

doi: 10.5455/IJMRCR.172-1671017763

Chorea as a rare neurological complication of hyperglycaemia

Catarina Lizardo Cruz, Rita Mendes, Margarida Quinto Pereira, Vikesch Rameschandre Samji, Sérgio Pereira, Francisco Silva, Isabel Madruga.

Abstract
Chorea is a hyperkinetic movement disorder characterised by brief involuntary, random, and irregular contractions. It’s caused by multiple conditions, including neurodegenerative diseases, cerebrovascular disease, structural damage to deep brain structures, neoplastic diseases, or metabolic derangements, such as hyperglycaemic states.
We present a case of an 81-year-old woman, with a history of long-term poorly controlled type 2 diabetes mellitus, admitted to the emergency department with hyperkinetic delirium in the last 48h. At examination, she presented with mild right central facial paresis, and involuntary bilateral movement of the four limbs, more prominent on the right side. Laboratory tests showed hyperglycaemia of 799 mg/dl with ketonemia of 5.2 mg/dL and glycated hemoglobin of 11%. Computed tomography (CT) scan of the brain showed bilateral hyperdensity of the corpus striatum. The treatments included glycemic control with insulin, intravenous fluids, and anti-epileptic drugs. A clinical improvement was observed however, the patient continued to show chorea-like movements of the four limbs. The magnetic resonance imaging (MRI) showed a T2-flair and T2-weighted area of hypo-intensity involving bilaterally the striatum corpus and the corresponding signal in T1. She was then diagnosed with hyperglycaemia-associated chorea and improved significantly after initiation and titration of clonazepam and tetrabenazine.
This case report pretends to highlight the importance of considering a rare manifestation of a very common disease. A hyperglycaemic state that can lead to cerebral lesions and specific neurological manifestations.

Key words: Chorea; diabetes mellitus; hyperglycaemia; dyskinesia; basal ganglia;

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How to Cite this Article

Pubmed Style

Cruz CL, Mendes R, Pereira MQ, Samji VR, SP, Silva F, Madruga I, . Chorea as a rare neurological complication of hyperglycaemia. Int J Med Rev Case Rep. Online First: 21 Feb, 2023. doi:10.5455/IJMRCR.172-1671017763

Web Style

Cruz CL, Mendes R, Pereira MQ, Samji VR, SP, Silva F, Madruga I, . Chorea as a rare neurological complication of hyperglycaemia. https://www.mdpub.net/?mno=100297 [Access: February 24, 2023]. doi:10.5455/IJMRCR.172-1671017763

AMA (American Medical Association) Style

Cruz CL, Mendes R, Pereira MQ, Samji VR, SP, Silva F, Madruga I, . Chorea as a rare neurological complication of hyperglycaemia. Int J Med Rev Case Rep. Online First: 21 Feb, 2023. doi:10.5455/IJMRCR.172-1671017763

Vancouver/ICMJE Style

Cruz CL, Mendes R, Pereira MQ, Samji VR, SP, Silva F, Madruga I, . Chorea as a rare neurological complication of hyperglycaemia. Int J Med Rev Case Rep, [cited February 24, 2023]; Online First: 21 Feb, 2023. doi:10.5455/IJMRCR.172-1671017763

Harvard Style

Cruz, C. L., Mendes, R., Pereira, M. Q., Samji, V. R., , S. P., Silva, F., Madruga, I. & (2023) Chorea as a rare neurological complication of hyperglycaemia. Int J Med Rev Case Rep, Online First: 21 Feb, 2023. doi:10.5455/IJMRCR.172-1671017763

Turabian Style

Cruz, Catarina Lizardo, Rita Mendes, Margarida Quinto Pereira, Vikesch Rameschandre Samji, Sérgio Pereira, Francisco Silva, Isabel Madruga, and . 2023. Chorea as a rare neurological complication of hyperglycaemia. International Journal of Medical Reviews and Case Reports, Online First: 21 Feb, 2023. doi:10.5455/IJMRCR.172-1671017763

Chicago Style

Cruz, Catarina Lizardo, Rita Mendes, Margarida Quinto Pereira, Vikesch Rameschandre Samji, Sérgio Pereira, Francisco Silva, Isabel Madruga, and . "Chorea as a rare neurological complication of hyperglycaemia." International Journal of Medical Reviews and Case Reports Online First: 21 Feb, 2023. doi:10.5455/IJMRCR.172-1671017763

MLA (The Modern Language Association) Style

APA (American Psychological Association) Style

Cruz, C. L., Mendes, R., Pereira, M. Q., Samji, V. R., , S. P., Silva, F., Madruga, I. & (2023) Chorea as a rare neurological complication of hyperglycaemia. International Journal of Medical Reviews and Case Reports, Online First: 21 Feb, 2023. doi:10.5455/IJMRCR.172-1671017763

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