TY - JOUR
T1 - Bilateral dystonia in type 1 diabetes
T2 - A case report
AU - Yasuhara, Akihiro
AU - Wada, Jun
AU - Makino, Hirofumi
N1 - Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.
PY - 2008/11/18
Y1 - 2008/11/18
N2 - Introduction: Diabetic hemichorea-hemiballismus is a rare complication of type 2 diabetes. Here, we report a case with type 1 diabetes, with hemichorea and bilateral dystonia manifested as hyperglycemia-induced involuntary movement. Case presentation: A 62-year-old Japanese women with body weight loss of 30 kg during the past year developed symptoms of thirst, polydipsia and polyuria. She also presented with hemichorea and bilateral dystonia for 5 days and extremely high plasma glucose (774 mg/dl), hemoglobin A1c (21.2%) and glycated albumin (100%) with ketosis. Based on the presence of glutamic acid decarboxylase antibodies (18,000 U/ml; normal <1.3 U/ ml), low daily urinary excretion of C-peptide (7.8 μg), ketosis and human leucocyte antigen typing DR-4, we diagnosed type 1 diabetes mellitus. We treated the patient with a continuous intravenous regular insulin infusion and medication with haloperidol, and dystonia completely disappeared within 3 days. Conclusion: Hyperglycemia-induced involuntary movement is one of the manifestations of dystonia and hemichorea-hemiballism.
AB - Introduction: Diabetic hemichorea-hemiballismus is a rare complication of type 2 diabetes. Here, we report a case with type 1 diabetes, with hemichorea and bilateral dystonia manifested as hyperglycemia-induced involuntary movement. Case presentation: A 62-year-old Japanese women with body weight loss of 30 kg during the past year developed symptoms of thirst, polydipsia and polyuria. She also presented with hemichorea and bilateral dystonia for 5 days and extremely high plasma glucose (774 mg/dl), hemoglobin A1c (21.2%) and glycated albumin (100%) with ketosis. Based on the presence of glutamic acid decarboxylase antibodies (18,000 U/ml; normal <1.3 U/ ml), low daily urinary excretion of C-peptide (7.8 μg), ketosis and human leucocyte antigen typing DR-4, we diagnosed type 1 diabetes mellitus. We treated the patient with a continuous intravenous regular insulin infusion and medication with haloperidol, and dystonia completely disappeared within 3 days. Conclusion: Hyperglycemia-induced involuntary movement is one of the manifestations of dystonia and hemichorea-hemiballism.
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U2 - 10.1186/1752-1947-2-352
DO - 10.1186/1752-1947-2-352
M3 - Article
C2 - 19017374
AN - SCOPUS:58149086569
VL - 2
JO - Journal of Medical Case Reports
JF - Journal of Medical Case Reports
SN - 1752-1947
M1 - 352
ER -