Abstract

ESPIN CHICO, Blanca Beatriz; PROANO LUCERO, Silvia Araceli  and  ALTAMIRANO CALDERON, Alex Mauricio. Long duration hemichorea associated with metabolic disorder. Rev. virtual Soc. Parag. Med. Int. [online]. 2019, vol.6, n.2, pp.84-89.  Epub Sep 01, 2019. ISSN 2312-3893.  https://doi.org/10.18004/rvspmi/2312-3893/2019.06.02.84-089.

Chorea associated with hyperglycemia represents a rare neurological syndrome, much more common among older Asian women. The pathophysiology remains controversial and poorly understood. However, theories have been proposed such as increased dopamine receptor sensitivity, striated nucleus infarction, increased gamma-aminobutyric acid metabolism and an alteration of the blood-brain barrier. We report that a 75-year-old woman, of indigenous race, was admitted to the Emergency Department due to severe random, involuntary and continuous movements in her right arm and leg that began 3 days earlier, accompanied by osmotic symptoms (polydipsia and polyuria). The level of capillary glucose at admission was 470.5 mg/dL, without traces of ketone in blood or urine, while the value of glycosylated hemoglobin was 15.4%. Nuclear magnetic resonance imaging reported hyperintensity in T1 of the left lenticular nucleus predominantly at the putamen level without other alterations. We describe aspects of the long duration of symptoms despite adequate treatment and metabolic control.

Keywords : chorea; hyperglycemia; movement disorder.

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