Non-ketotic hyperglycemia-induced hemichorea-hemiballism – A case presentation and literature review

Non-ketotic hyperglycemia-induced hemichorea-hemiballism (NKHHH) is an infrequent hyperkinetic movement disorder, also known as diabetic striatopathy or Chorea hyperglycemia basal ganglia syndrome (C-H-BG), characterized by repetitive, uncontrollable movements in the unilateral or bilateral limbs. An insult to the contralateral basal ganglia causes NKHHH to develop. NKHHH is caused by ischemia, followed by non-ketotic hyperglycemia and poorly controlled diabetes. NKHHH is a rare condition with a unique cause that only affects one side of the corpus striatum (caudate nucleus and putamen). Clinical events of hemichorea-hemiballism, laboratory tests (elevated blood glucose and hemoglobin A1c levels), and imaging modalities (computed tomography and magnetic resonance imaging) all contribute to diagnosing NKHHH. The objective of this case report is to represent cross-sectional imaging findings in a 55-year-old female who presented with hemichorea-hemiballism following non-ketotic hyperglycemia. In conclusion, the clinical manifestation of NKHHH and its computed tomography (CT) and magnetic resonance imaging (MRI) findings are crucial in determining the appropriate management.