Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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September 8, 2014
Hemichorea-Hemiballismus Syndrome
- Hemichorea-hemiballismus is a rare but dramatic complication of nonketotic hyperglycemia in patients with uncontrolled diabetes.
- It is characterized by continuous, irregular, and involuntary jerky movements of one side of the body, often the result of a focal lesion of the contralateral basal ganglia.
- The pathophysiology is presumed to involve ischemic changes in the striatum associated with hyperglycemia and hyperviscosity.
- Key Diagnostic Features: T1 hyperintensity in putamen contralateral to the side of involuntary movements
- DDx:
- Acute ischemic stroke
- Methemoglobin in intracranial hemorrhage
- Calcification
- Rx: When hyperglycemia is detected and corrected, the movement disorder usually resolves within a few days and may not require symptomatic therapy.
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