Hemiballismus, a subtype of chorea, is a rare movement disorder, and is most commonly found secondary to stroke. Movements are involuntary, violent, coarse, and have a wide amplitude. There is increasing report of hemiballismus occurring in non-ketotic hyperglycemia. Spontaneous improvements or remissions were observed in many patients, and treatment should be directed towards the cause of hemiballismus. There is no randomized control trial to guide clinicians in deciding the best treatment option when managing hemiballismus. Symptomatic treatment includes the use of drugs such as dopamine receptor blocker and tetrabenazine. Surgical treatment is reserved for severe, persistent, and disabling hemiballismus. This case is of an elderly woman with long standing uncontrolled diabetes who presented with abnormal movement in her left upper limb for 2 months, which resolved slowly with good control of her glucose levels. Treating physicians need to have a high index of suspicion to prevent mismanagement of the condition.

Citations

• Hemichorea in patients with temporal lobe infarcts: Two case reports
  Xu-Dong Wang, Xing Li, Chun-Lian Pan
  World Journal of Clinical Cases.2024; 12(4): 806.     CrossRef
• Bilateral Chorea-Ballism Associated With Non-ketotic Hyperglycemia: A Case Report
  Ouafae Abbassi, Amina Ali Kako, Yassine Mebrouk
  Cureus.2024;[Epub]     CrossRef
• Non-ketotic hyperglycaemic hemichorea-hemiballismus with Fahr’s disease in a Chinese family: a case report
  Si-Huan Zhu, Jin-Jin Peng, Ke-Fan Li, Jian-Cheng Peng, Jun Li
  International Journal of Neuroscience.2023; 133(11): 1242.     CrossRef
• Atypical Imaging Findings of Nonketotic Hyperglycemic Hemichorea: A Case Report and Review of the Literature
  Christopher M Stevens, Kevin Malone, Arielle Degueure, Amro Saad Aldine, Octavio Arevalo
  Cureus.2023;[Epub]     CrossRef
• Hemiballism and chorea with acute/subacute onset: a retrospective series
  Yeşim Güzey Aras, Sena Boncuk Ulaş, Türkan Acar, Bilgehan Atılgan Acar
  Acta Neurologica Belgica.2023; 123(2): 591.     CrossRef
• Bilateral striatum with high-signal intensity on T1-weighted MRI: A case of hemichorea induced by nonketotic hyperglycemia
  Yuanyi Pan, Fattyang Chew, Rongping Wang, Xuntao Yin, Yaying Li
  Radiology Case Reports.2021; 16(4): 895.     CrossRef
• Haemichorea–haemiballism associated with poorly controlled type 2 diabetes mellitus (a video demonstration)
  Shun Yamashita, Masaki Tago, Shu-ichi Yamashita
  BMJ Case Reports.2021; 14(4): e242949.     CrossRef
• La striatopathie diabétique : une complication rare et traitable du diabète sucré
  N. Gouta, S. Younes, B. Hidouri, H. Bouguila, F. Boubaker
  NPG Neurologie - Psychiatrie - Gériatrie.2021; 21(126): 424.     CrossRef
• Diabetes and neurology: hemichorea–hemiballism in hyperglycaemia
  Kim Yen Galloway, Osman Younus, Graziella Quattrocchi, Bazo Raheem, George Dervenoulas, Eli Silber
  Clinical Medicine.2020; 20(2): s21.     CrossRef
• Hemiballismus in subcortical lacunar infarcts
  ChinyeluUchenna Ufoaroh, OvercomerNnaemeka Agah, Nnamdi Morah, ErnestNdukaife Anyabolu
  Nigerian Journal of Medicine.2020; 29(3): 527.     CrossRef
• Hemiballismus Presenting as a Metabolic
  Debipriya Saha, Kanak Choudhury
  Bengal Physician Journal.2020; 6(3): 74.     CrossRef
• Corea secundaria a hiperglucemia no cetósica: a propósito de un caso
  E. Esteban-Zubero, R. Castejón-Moreno, C. García-Muro, M.A. Alatorre-Jiménez, A. Marín-Medina
  Medicina de Familia. SEMERGEN.2019; 45(8): 569.     CrossRef
• Investigation of the relationship between non-ketotic hyperglycemia and hemichorea-hemiballism
  Po-Jen Hsiao, Chih-Chun Kuo, Tai-You Kuo, Yung-Hsi Kao, Jenq-Shyong Chan, Yen-Yue Lin, Ming-Hua Chen, Jin-Shuen Chen, Chih-Pin Chuu
  Medicine.2019; 98(28): e16255.     CrossRef