Tetrabenazine for hyperglycemic‐induced hemichorea–hemiballismus

  title={Tetrabenazine for hyperglycemic‐induced hemichorea–hemiballismus},
  author={Oraporn Sitburana and William G Ondo},
  journal={Movement Disorders},
We reported a 74‐year‐old woman with new‐onset diabetes mellitus who presented with the sudden onset of mild left hemiparesis and marked left hemichorea–hemiballismus. Brain CT scan and MRI showed T1W, T2W, and DWI lesions in the right putamen and caudate, which have been previously reported in cases of hyperglycemic‐induced hemichorea–hemiballismus (HIHH). The patient dramatically responded to tetrabenazine within a day. Subsequent dose reductions lead to a reemergence of symptoms… 

[Hemiballism-hemichorea with non-ketotic hyperglycemia: movement disorder related to diabetes mellitus].

A 75 year-old male patient admitted with history of hemiballismus-hemichorea movements, hyperglycemia, glycated hemoglobin of 14.4% and CT with a hyperdense area in the topography of the right basal ganglia is presented.

Dual Treatment of Hemichorea–Hemiballismus Syndrome with Tetrabenazine and Chemodenervation

A 65-year-old male developed left hemichorea–hemiballismus and dystonia after a right hemisphere stroke and treatment with tetrabenazine and chemodenervation reduced the dySTONia.

Non-ketotic Hyperglycemia Presenting with Acute Hemichorea and Ballism

  • P. Bollu
  • Medicine
    American Journal of Hospital Medicine
  • 2018
The case of an elderly woman who presented with hemichorea-ballism due to non-ketotic hyperglycemia is reported and the differential diagnosis based on neuroimaging is highlighted.

Hemiballismus: current concepts and review.

An Unusual Case of Diabetes Mellitus: Ketone-Positive Hyperglycaemia Induced Hemichorea-Hemiballism

This case report reports the first case of ketone-positive HIHH in a Caucasian patient who had been on a Sodium Glucose Transporter 2 (SGLT-2) inhibitor and postulated whether there was a relationship between her basal ganglia injuries and possible cognitive decline which may have affected her adherence to blood glucose lowering therapy.


Clinical manifestations and supporting patients support hyperglycemia and basal ganglia hyperdensity to be the etiology of hemiballismus experienced by patients.

Unilateral hemichorea and hemiballismus: Rare complications of non-ketotic hyperglycemia

The case of a 65-year-old male, known hypertensive, diabetic with the left eye retinopathy who presented with the chief complaints of sudden onset hemichorea and hemiballismus on the right upper and lower limbs is presented.

Contralateral Basal Ganglia Atrophy in Acquired Hemichorea- Hemiballism

A patient with HCHB in the setting of poorly controlled chronic diabetes, who also demonstrated basal ganglia atrophy on follow-up imaging is described, which is rarely reported.

Hyperglycemic nonketotic states and other metabolic imbalances.

  • W. Ondo
  • Medicine
    Handbook of clinical neurology
  • 2011



Hemiballism-hemichorea and non-ketotic hyperglycaemia.

  • J. J. LinM. Chang
  • Medicine, Biology
    Journal of neurology, neurosurgery, and psychiatry
  • 1994
The hypersensitivity of the postmenopausal dopamine receptor, decreased gamma-aminobutyric acid in the brain in non-ketotic hyperglycaemia, coexisting lacunar infarct in the basal ganglion, and pre-existing metabolic dysfunction in the Basal Ganglion may all have played a part in the pathogenesis of this movement disorder.

Case report Non‐ketotic hyperglycemia in a young woman, presenting as hemiballism‐hemichorea

A 22‐year‐old girl presenting with acute onset left sided hemiballism‐hemichorea (HH) and non‐ketotic hyperglycemia (NKH) and an update on current literature regarding the possible pathophysiological processes underlying this specific clinical entity is reported.

Transient Hemichorea/Hemiballismus Associated with New Onset Hyperglycemia

It is believed that the combination of a recent or old striatal lesion and hyperglycemia (causing decreased GABAergic inhibition of the thalamus) may be responsible for the appearance of this unilateral hyperkinetic movement disorder.

Hemiballism-hemichorea. Clinical and pharmacologic findings in 21 patients.

In this series of 21 patients with hemiballism-hemichorea, an identifiable cause in all patients was found, and other subcortical structures may be involved in the pathogenesis of this hemihyperkinesia.

Hemiballism with hyperglycemia and striatal T1‐MRI hyperintensity: An autopsy report

We report on an autopsy findings of a 92‐year‐old male with hemiballism‐hemichorea associated with hyperglycemia and striatal hyperintensity on T1‐weighed magnetic resonance imaging (MRI), a recently

Nonketotic hyperglycemia appearing as choreoathetosis or ballism.

Serum glucose level should be determined in anyone with the new onset of choreoathetosis or ballism, as hyperglycemia is a rapidly reversible cause of these conditions.

Persistent chorea triggered by hyperglycemic crisis in diabetics

The chorea developed subacutely over 2 days to 1 month and was generalized in one, unilateral in three, and involved right > left lower extremity in the other; the severity initially reached ballistic proportions in two; the pathogenic mechanisms remain uncertain.