A Rare Clinical Presentation of Diabetes Mellitus
- *Corresponding Author:
- Gurshawn Singh
Department of Internal Medicine
University of Texas Southwestern
Dallas, Texas, USA
E-mail: [email protected]
Received date: February 29, 2016; Accepted date: March 03, 2016; Published date: March 08, 2016
Citation: Batra V, Singh G (2016) A Rare Clinical Presentation of Diabetes Mellitus. Immunochem Immunopathol 2:116. doi: 10.4172/2469-9756.1000116
Copyright: © 2016 Batra V, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
This case report highlights a rare presentation of new-onset diabetes. Hemichorea- hemiballismus due to nonketotic hyperglycemia is a rare disorder, which comprises of unilateral, periodic choreiform movement of the extremities in the setting of hyperglycemia without evidence of ketoacidosis. Radiographically, there is hyperdensity in the basal ganglia but no evidence of bleeding or mass effect on CT scan of the brain. MRI of the brain shows increased T1-signal intensity in the contralateral putamen. The immunopathology is hyperglycemia mediated, which causes ischemic excitation of GABAergic-neurons in the basal ganglia. This leads to excessive inhibition of subthalamic nuclei and excitatory cortical input causing involuntary movement unilaterally. The mainstay treatment of this condition is insulin therapy, and the movement disorder disappears once glycemic control is achieved.