Striatal hyperdensity in hemichorea patient: Case reports and review literatures.

ABSTRACT

Objective: To report three cases of a unique clinicoradiological manifestration of chorea associated with non-ketotic hyperglycemia. Methods: A retrospective review of clinical, radiological and laboratory findings in three patients with chorea associated with non-ketotic hyperglycemia and a review of relevant literature were done. Results: Three patients presented with acute hemichorea, two patients with a history of long standing diabetes mellitus and one without. The initial cranial CT scans revealed hyperattenuation at the basal ganglia contra-lateral to the side of chorea in two cases and bilateral involvement in one case. The laboratory findings showed a non-ketotic hyperglycemic state in all patients and, hence, hyperglycemia-induced chorea was diagnosed. Chorea in all patients responded well to treatment for hyperglycemia. Conclusion: Acute chorea associated with diabetic non-ketotic hyperglycemia may present with acute neurologic symptoms mimicking stroke. Recognition of this unique clinicoradiological appearance is important because correction of the underlying hyperglycemia will lead to rapid improvement of chorea.