Non-ketotic hyperglycaemia and the hemichoreahemiballismus syndrome – a rare paediatric presentation

Abstract

Hemichorea-hemiballismus may be due to non-ketotic hyperglycaemia, but this condition has rarely been described in paediatrics. We describe the case of a 13-year-old girl with newly diagnosed type 1 diabetes and acute onset of left-sided choreoathetoid movements. Neuroimaging revealed an area of hyperintensity in the right basal ganglia. Her blood glucose level at the time was 19 mmol/L, and there was no ketonuria. The hemiballismus improved with risperidone and glycaemic control. Repeat neuroimaging 4 months later showed complete resolution of the hyperintensities seen.