Hemichorea–Hemiballism after Diabetic Ketoacidosis
A 37-year-old man with insulin-dependent diabetes who had undergone kidney transplantation 7 years earlier presented with delirium caused by diabetic ketoacidosis. The patient's mental status normalized 2 days after the administration of insulin and intravenous hydration. Three weeks later, he noted that his right arm and right leg were "fidgety," a symptom that rapidly increased in intensity. The physical examination revealed right hemichorea with a ballistic component.
Definitions
Hemichorea—unilateral, rapid involuntary motions of flexion and extension, rotation or crossing, which may involve all body parts, but predominantly distal parts [1, 41].
Hemiballismus (hemiballism)—severe, violent, arrhythmic and large amplitude excursion of a limb from a proximal joint with an element of rotation [1, 41].
Dystonia—a syndrome characterised by prolonged muscle contractions causing sustained twisting movements and abnormal postures of the affected body part(s) [1, 6].
Tremor—rapid rhythmic oscillation generally of the hands [40].
Myoclonus—sudden, involuntary jerking of a single muscle or a group of muscles [41].
Athetosis—slow, sinuous, writhing movements affecting mainly the hands and feet [41].
Pseudoathetosis—abnormal writhing movements, usually of the fingers, caused by a failure of joint position sense (proprioception) [14, 42].
Asterixis—failure to sustain muscle contraction during postures with intermittent, generally arrhythmic lapses in muscle tone [41].
Parkinsonism—triad of bradykinesia, increased tone and tremor.
Movement disorders can be unilateral, bilateral, focal (affecting a single part of the body) or segmental (affecting two or more adjacent parts of the body).
Technically, you usually get hemiballism with nonketotic hyperglycemia more than ketoacidosis
Hi.
What is the difference between chorea and hemiballism?
I believe hemiballism is a stronger movements than chorea.
My mother -in-law has these same movements on her left size of her body.She is a diabetic and Her glucose levels was also high(600) .She is now in the hospital and have no insurance. and we feel all they are just doing is experimenting on her and she is not getting any better. please if anybody can help us understand, get more help or anything please response. Thanks
What hospital is going to do is to take care first of her high glucose levels. Then , once it is normalized or decreased some meds and physical therapy will be part of treatment. Sometimes it is not easy to take care of cause the patient might have more healthy issues and physical limitations .