Non-Ketotic Hyperglycemic Hemichorea as an initial manifestation of Type 2 diabetes mellitus: case report and review of the literature

Non-Ketotic Hyperglycemic Hemichorea (NKHCB) is a rare movement disorder associated with uncontrolled diabetes mellitus. It has been reported in type 2 diabetes, and much rarer in type 1 diabetes mellitus. It is characterized by hemichorea-hemiballism that resolves with glycemic control, though some cases may be unremitting. It has hardly been reported as the presenting complaint in a new diagnosis of diabetes mellitus. We hereby discuss a case of NKHCB as a first complaint in a 52-year-old lady not previously known to have diabetes. The CT scan did not reveal any abnormality. The disorder resolved within a month of the diagnosis after proper glycemic control and use of neuroleptic agents. NKHCB is an important differential diagnosis to consider in patients presenting with hemichorea-hemiballism, even if not previously known to be diabetic.