Chorea in diabetic non-ketotic hyperglycemia
by Kalyan B Bhattacharyya, Kalyan Satish V

Atlas of Neurology—A Case-based Approach

by Satish V Khadilkar, Kalyan B Bhattacharyya
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Chorea, hemichorea-hemiballismus and severe partial seizures may be the presenting features of uncontrolled T2 diabetic non-ketotic hyperglycemia in elderly subjects. It is associated with hyperintensity in the contralateral basal ganglia. The pathophysiology is not precisely known. It is suggested that hyperglycemia leads to disruption of blood-brain barrier and the regional blood flow is reduced. This in turn, leads to intracellular acidosis, increase in extracellular glutamate, cytotoxic and vasogenic edema, and reduced activity of amino butyric acid-encephalin inhibition. Otherwise, petechial hemorrhages, myelinosis, and calcification are the suggested mechanisms.

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