HEMIBALLISMUS-HEMICHOREA IN A 55 YEARS OLD DIABETIC FEMALE PATIENT WITH NON-KETOTIC HYPERGLYCAEMIA

Abstract

Hemiballismus-hemichorea (HC-BC) are involuntary rapid irregular jerks, invariably unilateral and affect the arms more frequently than legs1. The causative lesion is commonly found in the corpus striatum, but can occur anywhere along the afferent or efferent pathways connecting the striatum to its projection areas. Although the most common cause of HC-BC is a cerebrovascular insult in the region of the striatum and subthalamic nucleus but a variety of pathologies including tumors, neurodegenerative disorders, encephalitis, drugs, systemic lupus erythematosus, and metabolic disorders have been implicated as a cause2. Non-ketotic hyperglycaemia a in newly diagnosed or poorly controlled diabetic has been described as a metabolic case of Hemiballismus-hemichorea particularly in elderly female patients2. More dramatic ballistic movements of limbs usually occurs unilaterally in vascular lesions of subthalamic lesions3 .