What is Hemiballismus Hemichorea?

Hemichorea-hemiballism (HCHB) is a hyperkinetic disorder characterized by continuous, nonpatterned, proximal, involuntary movements on one side of the body, resulting from involvement of the contralateral basal ganglia and particularly the striatum.

What is the treatment for Hemiballismus?

Hemiballismus is usually treated with antipsychotics, such as haloperidol and clozapine, but thalamic ablation is considered in severe cases if there is no response to medical therapies.

Can hyperglycemia cause chorea?

Hyperosmolar hyperglycemic non-ketotic (HHNK) syndrome is a clinical syndrome of severe hyperglycemia, hyperosmolarity, and intracellular dehydration without ketoacidosis [1]. Chorea is characterized by involuntary random-appearing irregular movements that are not rhythmic or repetitive.

What is diabetic Striatopathy?

Diabetic striatopathy is a syndrome characterized by presence of increased signal with the corpus striatum on T1WI, with contralateral hyperkinetic movement disorders or fleeting sensory-motor manifestations. Commonly observed in patients with type 2 DM, it is less often seen in patients with type 1 DM.

Is Hemiballismus a type of chorea?

Chorea typically involves the face, mouth, trunk, and limbs. Athetosis is a continuous stream of slow, flowing, writhing involuntary movements. It usually affects the hands and feet. Hemiballismus is a type of chorea, usually involving violent, involuntary flinging of one arm and/or one leg.

What causes Choreiform movements?

Chorea is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias, which are caused by overactivity of the neurotransmitter dopamine in the areas of the brain that control movement.

What causes Ballismus?

Ballismus is a severe movement disorder that is characterized by spontaneous involuntary movements, muscular weakness and incoordination of movements of the proximal extremities. It is mostly caused by neurodegenerative, vascular, toxic metabolic, infectious or immunological process affecting the basal ganglia.

What is hyperglycemic chorea?

Chorea hyperglycemia basal ganglia syndrome (CHBG) is a rare condition that manifests in the setting of uncontrolled nonketotic diabetes mellitus. It is best characterized by the manifestation of hemichorea-hemiballism with uncontrolled blood sugar levels.

What is the name of the disorder which causes chorea?

Chorea is the most common symptom of Huntington’s disease. In the United States, about 4,000 kids a year develop Sydenham chorea after having rheumatic fever. Rheumatic fever is a serious complication of untreated strep throat.

What is Striatopathy?

Diabetic striatopathy is a rare disorder that usually presents with a variety of hyperkinetic movement disorders, and is associated with poor glycaemic control. 1 It is more prevalent in elderly diabetic women with poor glycaemic control (mostly type 2 DM but can occur in type 1 DM).

Why is Hemiballismus contralateral?

The subthalamic nucleus essentially provides the excitement needed to drive the globus pallidus. Injury to this area or its efferent or afferent connections can induce this disorder contralateral to the side of the lesion.

What lesion causes Hemiballismus?

Hemiballismus is usually caused by a lesion in the contralateral STN. This is usually an infarct around the nucleus. This condition is very rare and is classified as a type of chorea. Additional causes of hemiballismus include traumatic brain injury, ALS, neoplasms, demyelinating plaques, and others.

What is non ketotic hyperglycaemic hemichorea (NHH)?

Non-ketotic hyperglycaemic hemichorea (NHH), also known as diabetic striatopathy or chorea, hyperglycemia, basal ganglia (C-H-BG) syndrome, is a rare cause of T1 bright basal ganglia and one of the neurological complications of non-ketotic hyperglycaemia, along with non-ketotic hyperosmolar coma and non-ketotic hyperglycaemic seizures.

What is the pathophysiology of hemichorea-hemiballismus in type 2 diabetes?

Hemichorea-hemiballismus is a rare complication of nonketotic hyperglycaemia in type 2 diabetes. It is associated with contralateral striatal radiological abnormality, most typically T1 hyperintensity on MRI. We report a case of a 91 year old woman who presented in a nonketotic hyperglycaemic state with right sided hemichorea.

What is nonketotic hyperglycemia?

Nonketotic hyperglycemia is a rare cause of hemichorea-hemiballismus. It is more common among postmenopausal woman and can be the first presentation of diabetes mellitus ( 1 ).

Where to find radiology for hemichorea-hemiballismus?

1 Department of Radiology, Alfred Hospital, Commercial Road, Prahran, Victoria 3181, Australia. [email protected] Hemichorea-hemiballismus is a rare complication of nonketotic hyperglycaemia in type 2 diabetes. It is associated with contralateral striatal radiological abnormality, most typically T1 hyperintensity on MRI.