Volume 2013 Supplement 1

7th Asia Pacific Paediatric Endocrine Society (APPES) Biennial Scientific Meeting

Open Access

Hemichorea in 15-year-old patient with poorly controlled type 1 diabetes mellitus

  • Yong Hyuk Kim1 and
  • Ho-Seong Kim1
International Journal of Pediatric Endocrinology20132013(Suppl 1):P17

https://doi.org/10.1186/1687-9856-2013-S1-P17

Published: 3 October 2013

Introduction

Hemichorea, spontaneous unilateral involuntary movements and contralateral neuroimaging abnormalities of the striatum may be the presenting feature of nonketotic hyperglycemia in older adults with type 2 diabetes, but cases in children with type 1 diabetes are very rare.

Case

A 15-year-old woman with a 6-year history of type 1 DM developed righthemichorea. She presented continuous involuntary choreic movements of both herright arm and leg. The movements were nonsuppressible and ceased only during sleep.With the exception of this movement disorder, other neurological examination was unremarkable. On funduscopic examination, nonproliperative diabetic retinopathy was detected. The following laboratory findings were notable: fasting blood glucose 162 mg/dL, serum osmolarity 305 mOsm/L, and HbA1c 13.2%. Urinalysis was negative for glucose, ketones, and protein. There were no signs of diabetic ketoacidosis, hypoglycemia, hyperosmolar hyperglycemic coma, or rheumatic fever.Cranial computed tomographic scan showed that hyperattenuation of the left basal ganglia. T1-weighted magnetic resonance image demonstrated that hyperintensity of the left striatum.The hemichorea was slowly controlled with small oral doses of haloperidol (1.5 mg/d) and intensive blood glucose control.

Conclusion

We report the case of a 15-year-old poorly controlled diabetic adolescent girl who developed acute hemichorea of the right arm and leg in whom T1-weighted magnetic resonance imaging of the brain revealed hyperintense signal in left basal ganglia.

Authors’ Affiliations

(1)
Department of Pediatrics, College of Medicine, Yonsei University

Copyright

© Kim and Kim; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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