Al-Anbagi Usamah, Mohamedali Mohamed, Ahmad Muayad K, Sharif Muhammad, Nashwan Abdulqadir J
Internal Medicine, Hamad Medical Corporation, Doha, QAT.
Nursing & Midwifery Research, Hamad Medical Corporation, Doha, QAT.
Cureus. 2025 May 13;17(5):e84067. doi: 10.7759/cureus.84067. eCollection 2025 May.
Non-ketotic hyperglycemic hemichorea-hemiballismus (NHH) is a rare but reversible movement disorder associated with poorly controlled diabetes mellitus. It is characterized by involuntary, non-suppressible choreiform, ballistic movements or several other involuntary movements (dystonia, tremors, etc), contralateral striatal hyperintensity on MRI, and hyperglycemia without ketosis. The exact pathophysiology remains unclear, but prompt glycemic control is essential for symptom resolution. We report the case of a 41-year-old man with no prior history of diabetes who presented with an acute onset of hemichorea affecting the left upper and lower limbs. Laboratory findings revealed hyperglycemia (18 mmol/L) with an elevated HbA1c (>12%), while brain MRI demonstrated characteristic T1 hyperintensity in the right basal ganglia. The patient was started on insulin therapy and oral antihyperglycemic agents, along with neuroleptics for symptomatic relief. By the third day of treatment, his movements began to improve. This case underscores the importance of recognizing NHH in patients with new-onset movement disorders, emphasizing the role of neuroimaging and early glycemic management for favorable outcomes.
非酮症高血糖性偏侧舞蹈症-偏侧投掷症（NHH）是一种罕见但可逆转的运动障碍，与糖尿病控制不佳有关。其特征为不自主、不可抑制的舞蹈样、投掷样动作或其他几种不自主运动（肌张力障碍、震颤等），MRI显示对侧纹状体高信号，且血糖升高但无酮症。确切的病理生理学仍不清楚，但迅速控制血糖对于症状缓解至关重要。我们报告一例41岁男性病例，该患者既往无糖尿病史，急性起病，出现累及左上肢和下肢的偏侧舞蹈症。实验室检查发现血糖升高（18 mmol/L），糖化血红蛋白升高（>12%），而脑部MRI显示右侧基底节有特征性T1高信号。患者开始接受胰岛素治疗和口服降糖药，同时使用抗精神病药物缓解症状。治疗第三天，他的运动开始改善。该病例强调了在新发运动障碍患者中识别NHH的重要性，突出了神经影像学和早期血糖管理对取得良好预后的作用。
