Chorea-Ballismus Associated With Nonketotic Hyperglycemia Without Hyperosmolality: A Case Report

A 77 years old diabetic voman presented with a sudden onset of generalized chorea-ballismus (CB). Laboratory screening revealed uncontrolled diabetes with absent ketones and normal serum osmolality. There were no any abnormalities on magnetic resonance imaging (MRI) that can explain these involuntary movements. Insuline theraphy combined with neuroleptic abolished the involuntary movements completely within 4 days. This excellent prognosis supports the hypothesis that direct effect of hyperglycemia without hyperosmolality may cause CB by neuronal dysfunction in basal ganglia. The involuntary movements can be corrected with blood glucose control within a short time and neuroleptic theraphy may not be required.