Behind the movements
DOI:
https://doi.org/10.32818/reccmi.a9n3a2Keywords:
hyperglycemia, chorea, movements, hyperosmolarityAbstract
The case involves a 90-year-old man with type 2 diabetes who was admitted for a respiratory infection. He had
experienced hyperosmolar hyperglycemic decompensations (blood glucose 500 mg/dL) in the weeks prior and in
the context of recurrent respiratory infections. During the examination, irregular, repetitive and brief involuntary
movements affecting the proximal left upper limb were observed, leading to a diagnosis of left hemichorea syndrome.
After ruling out pharmacological and vascular causes, hemichorea due to nonketotic hyperosmolar hyperglycemia
syndrome (HHS) was confirmed through clinical history and magnetic resonance imaging. Following
hydration, bolus-basal insulin therapy and antikinetic treatment, partial symptomatic improvement was noted,
although residual hyperkinetic motor disorder episodes persisted.experienced hyperosmolar hyperglycemic decompensations (blood glucose 500 mg/dL) in the weeks prior and in the context of recurrent respiratory infections. During the examination, irregular, repetitive and brief involuntary movements affecting the proximal left upper limb were observed, leading to a diagnosis of left hemichorea syndrome. After ruling out pharmacological and vascular causes, hemichorea due to nonketotic hyperosmolar hyperglycemia syndrome (HHS) was confirmed through clinical history and magnetic resonance imaging. Following hydration, bolus-basal insulin therapy and antikinetic treatment, partial symptomatic improvement was noted, although residual hyperkinetic motor disorder episodes persisted.
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