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- Hyperglycaemic hemiballism
- subthalamic nucleus
- diabetes mellitus
- movement disorders
Non-ketotic hyperglycaemia is one of the causes of hemiballism.1 2 The involuntary movement is also sometimes referred to as hemichorea. Hyperglycaemic hemiballism has been thought to occur in patients with pooly controlled diabetes. MRI usually shows a hyperintense lesion of the contralateral basal ganglia in T1-weighted image.3 Although there have been a few pathological studies of hyperglycaemic hemiballism, no studies have shown pathological alteration in the subthalamic nucleus (corpus Luysii) which is responsible for the hemiballism resulting from ischaemia.4 Originally, Schwarz and Barrows reported hyperglycaemic hemiballism as ‘hemiballism without involvement of Luys' body.’2 We herein report a case of hyperglycaemic hemiballism in which immunohistochemistry showed the presence of activated microglia in the subthalamic nucleus contralateral to the hemiballism.
A 59-year-old man was admitted because of involuntary movement of his right arm that had progressed over 3 days. He had had diabetes mellitus for 19 years treated with insulin injections. Three years prior to admission, he was started on continuous ambulatory peritoneal dialysis (CAPD) due to diabetic nephropathy. One month prior to admission, he began …
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