Clinical features, neuroimaging findings and treatment outcomes in non ketotic hyperglycemic hemichorea-hemiballismus
Journal Title: Indian Journal of Neurosciences - Year 2018, Vol 4, Issue 4
Abstract
Introduction Nonketotic hyperglycemic hemichoreahemiballism NKHH is an uncommon hyperkinetic movement disorder It is the second most common etiologyafter stroke affecting basal ganglion Only a few hundred cases are reported so far in literatureObjectives The study attempts to systematically highlight clinical profile and neuroimaging findings in 15 patients of Nonketotic hyperglycemic hemichoreahemiballismMaterials and Methods Patients with hemichorea hemiballism associated with hyperglycemia were included in the study The period of the study was from January 2008 to September 2018 Neurological examination Demographic data clinical biochemical and neuroimaging findings were captured from the medical records Details of the involuntary hyperkinetic movements such as type and sides involved were noted Treatment was aimed to control glycemic status and neuroleptic drugs Descriptive statistics were used wherever necessaryResults During the study period 52 patients had hemichorea hemiballismus27 patients had stroke affecting basal ganglia6 patients had granuloma affecting basal ganglia 4 patients had Wilsons disease15 patients had NKHH Among 15 patients of NKHH 9 patients were females and 6 were males Female to male 151The mean age at the onset was 702 years Range 58 85 The mean serum glucose levels measured after the onset of NKHH was 43993 mgdL Range 342532The mean glycated haemoglobin was 1098 Range 91185Neuroimaging showed involvement of striatum in 13 patientsConclusion NKHH is a rare hyperkinetic movement disorder Elderly poorly controlled diabetics and female sex are most commonly affected Neuroimaging findings are distinct Further studies are needed to elucidate pathogenesis of this disease and for determining prognosticating factorsKeywords Non ketotic hyperglycemia Hemichoreahemiballism Putamen Striatum
Authors and Affiliations
Sagar Badachi, Raghunandan Nadig, G R K Sarma, Sharath Kumar GG, Thomas Mathew
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