Authors
Racheed Mani, Tiffany Kim, Thomas Kim, Chiemeka Uwakwe, Camelia Yuejiao Zheng, Sima Mofakham, Eltonnelle James, Charles Mikell, Guy Schwartz
Published in
Movement disorders clinical practice. Jul 06, 2026. Epub Jul 06, 2026.
Abstract
Hemiballismus/hemichorea can manifest as a systemic sequala of severe hyperglycemia. This typically resolves with optimal glycemic control supplemented by neuroleptic agents. However, in a subset of patients, this hyperkinetic movement disorder may persist despite maximal medical management.
We present a 70-year-old man with type 2 diabetes mellitus (DM) who presented with 6 months of right-sided hemiballismus/hemichorea that started after a previous episode of nonketotic hyperglycemia. Despite optimal glucose control and the administration of several neuroleptic agents, his symptoms failed to resolve. He underwent left-sided deep brain stimulation (DBS) to the globus pallidus internus (GPi), with subsequent improvement in his hyperkinetic movements.
We document 7 cases in the literature of posthyperglycemic chorea-ballism (PHGCB) treated with either pallidal or thalamic DBS or pallidotomy. The procedures were safe and well tolerated, and all patients demonstrated clinical improvement following surgery.
PHGCB represents a rare but serious complication of DM. There is a subset of patients who fail to respond to maximal medical therapy. Our illustrative case and review demonstrate that these patients may benefit from neurosurgical intervention. Further studies with long-term follow-up are warranted to substantiate the value of surgical approaches for medically refractory diabetic striatopathy.
PMID:
42410315
Bibliographic data and abstract were imported from PubMed on 07 Jul 2026.
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