Chorea in Non-Ketotic Hyperglycemia

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Michael Modica Kevin Nesh Najy Masri


Chorea is an involuntary, irregular, poorly patterned movement that is associated with a wide variety of illnesses. In this case, we describe a 71-year-old female who presented with choreiform movements after a change to her diabetes medication regimen. The patient was found to have non-ketotic hyperglycemia and was admitted to the hospital for insulin and rehydration. Once the patient’s blood glucose was controlled, her choreiform movements resolved. MRI showed no abnormal findings. In previous case reports, MRI showed hyperintense lesions in the putamen. Although the pathophysiology behind this finding is unclear, several mechanisms have been hypothesized including dopamine hypersensitivity and GABA depletion. We present this case in order to demonstrate the need to consider non-ketotic hyperglycemia in a patient with new onset choreiform movements without typical MRI findings.

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How to Cite
MODICA, Michael; NESH, Kevin; MASRI, Najy. Chorea in Non-Ketotic Hyperglycemia. Medical Research Archives, [S.l.], n. 2, apr. 2015. ISSN 2375-1924. Available at: <>. Date accessed: 22 july 2018.
hyperglycemia; choreiform movement; chorea
Case Reports


1. Hennis, A, D Corbin, H Fraser. “Focal Seizures and Non-Ketotic Hyperglycemia.” Journal of Neurology, Neurosurgery, and Psychiatry 55 (1992): 195-197. Accessed February 25, 2015.

2. Lee, Seung-Hwan, Jeong-Ah Shin, Jang-Won Kim et al., “Chorea-ballism associated with nonketotic hyperglycaemia or diabetic ketoacidosis: characteristics of 25 patients in Korea.” Diabetes Research and Clinical Practice 93.2 (2011): 80-83. Accessed November 9, 2014.

3. Lin, Juei-Juang, and Ming-Key Chang. "Hemiballism - Hemichorea and Nonketotic Hyperglycemia." Journal of Neurology, Neurosurgery, and Psychiatry 57 (1994): 748-50. Accessed November 10, 2014.

4. Lin, Juei-Juang, Ging-Yau Lin, and Chunhsi Shih. "Presentation of Striatal Hyperintensity on T1-weighted MRI in Patients with Hemiballism-hemichorea Caused by Non-ketotic Hyperglycemia: Report of Seven New Cases and a Review of Literature." Journal of Neurology 248.9 (2001): 750-55. Accessed November 12, 2014.

5. Rector, William, Franklin Herlong, and Hamilton Moses. “Nonketotic hyperglycemia appearing as choreoathetosis or ballism.” Archives of Internal Medicine 142 (1982): 154-155. Accessed November 9, 2014.

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