Hyperosmolar non-ketotic hyperglycaemic hemichorea as a presentation of diabetic striatopathy: importance of early recognition

Diabetic striatopathy (DS) is a rare neurological complication of hyperglycaemia. It is typically diagnosed when high blood glucose levels are accompanied by abnormal movements and/or characteristic findings on neuroimaging. We describe a rare case of DS with progressive hemichorea, distinctive MRI findings and non-ketotic hyperglycaemia. After 2 weeks of optimal glycaemic control combined with antichorea medications, as well as additional treatments for DS-associated comorbidities, the patient's condition improved significantly. This case underscores the importance of measuring blood glucose in patients presenting with involuntary movements.