HEMICHOREA-HEMIBALLISM IN VARIOUS CONDITIONS: SERIAL CASE REPORTS

Neila Raisa, Sri Budhi Rianawati, Shahdevi Nandar Kurniawan, Fahimma F, Mulika Ade Fitria Nikmahtustsani
  MNJ, pp. 74-79  
DOI: http://dx.doi.org/10.21776/ub.mnj.2021.007.01.15

Abstract


Introduction: Hemichorea-hemiballism (HCHB) is an uncommon movement disorder involved unilateral extremities characterized by irregular, poorly patterned, a continual hyperkinetic involuntary movement disorder in the proximal or distal parts of the body. The acute development of HCHB depends on focal lesions on the contralateral basal ganglia and subthalamic nuclei. Various conditions such as cerebrovascular, neurodegenerative, neoplastic, immunologic, infectious, and metabolic diseases are known as secondary causes of HCHB. This paper aims to compare and discuss the HCHB in various etiologies.

Case Reports: Here, we reported 5 cases of HCHB induced by non-ketotic hyperosmolar hyperglycemia (NKKH), thrombotic stroke, and toxoplasmosis cerebral. We compare the admission data, clinical course, imaging, treatment, and outcome of every case.

Conclusion: Various hypotheses have been proposed to explain the pathophysiology of HCHB due to these conditions. Principally, the main management for these cases is to determine the etiology and correct the underlying disorder

Keywords


Hemichorea-Hemiballism, Non-Ketotic Hyperosmolar Hyperglycemia, Thrombotic Stroke, Toxoplasmosis Cerebral

Full Text:

PDF

References


Daroff, Robert B, Joseph Jankovic, John C Mazzotta, Scott L Pomeroy. Bradley’s neurological in clinically practice. Seventh Edition. USA; 2015.

Chang, et al. Chorea-Ballism as a manifestation of decompensated type 2 diabetes mellitus. Am J Med Sci; 2007. 333 (3): 175-177.

DOI: 10.1097/MAJ.0b013e3180318e34

Lee SH, Shin JA, Kim JH, Son JW, Lee KW, Ko SH, Yang SH, Son BC, Ahn YB. Chorea-ballism associated with nonketotic hyperglycaemia or diabetic ketoacidosis: Characteristics of 25 patients in Korea. Diabetes Research and Clinical Practice; 2011. Aug 1;93(2):e80-3.

Chen C, Zheng H, Yang L, Hu Z. Chorea-ballism associated with ketotic hyperglycemia. Neurological Sciences; 2014. Dec 1;35(12):1851-5.

DOI: 10.1007/s10072-014-1968-1

Bizet J, Cooper CJ, Quansah R, Rodriguez E, Teleb M, Hernandez GT. Chorea, hyperglycemia, basal ganglia syndrome (CH-BG) in an uncontrolled diabetic patient with normal glucose levels on presentation. The American Journal of Case Reports. 2014;15:143. DOI: 10.12659/AJCR.890179

Hawley SJ, Weiner WJ. Hemiballismus: Current concepts and review. Parkinsonism and Related Disorders; 2012. 18:125-129.

DOI: 10.1016/j.parkreldis.2011.08.015

Bhidayasiri R, Truong DD. Chorea and related disorders. Postgraduate Medical Journal; 2004. Sep 1;80(947):527-34. DOI: 10.1136/pgmj.2004.019356

Ohara S. Diabetic Hemichorea-hemiballism. Austin J Clin Neurol; 2015. 2(4):1-6. Avalaible form: https://austinpublishinggroup.com/clinical-neurology/fulltext/ajcn-v2-id1037.php

Abe Y, Yamamoto T, Soeda T, Kumagai T, Tanno Y, Kubo J, et al. Diabetic striatal disease: Clinical presentation, neuroimaging, and pathology. Intern Med; 2009. 48:1135–41.

DOI: 10.2169/internalmedicine.48.1996

Alkilani WZ, Tahir H, Gibb N, Ullah S, Vinod NR. Hyperglycemia induced reversible hemiballismus as the main presentation of newly diagnosed diabetes mellitus. American Journal of Medical Case Reports; 2016. 4(7):245-7. Avalaible from: http://www.anncaserep.com/full-text/accr-v1-id1097.php

Burn, David. Oxford Textbook of Movement Disorder. Oxford University Press. USA; 2013.

Chung SJ, Im JH, Lee MC, Kim JS. Hemichorea after stroke: clinical-radiological correlation. J Neurol 2004; 251: 725–9. DOI: 10.1007/s00415-004-0412-5

Cambrea SC, Pascu C, Rugina S. Hemiballismus in a patient with acquired immunodeficiency syndrome and toxoplasma infection. Romanian Journal of Infectious Diseases; 2017. Jan 1;20(1)

Cressman S, Rheinboldt M, Lin D, Blasé J. Nonketotic hyperglycemia-induced hemichorea-hemiballism. Applied Radiology. 2018 Jun 1;47(6):24-6. Avalaiblr form: https://www.appliedradiology.com/articles/nonketotic-hyperglycemia-induced-hemichorea-hemiballism

Priola AM, Gned D, Veltri A, Priola SM. Case 204: nonketotic hyperglycemia-induced hemiballism-hemichorea. Radiology; 2014. Apr;271(1):304-8. DOI: 10.1148/radiol.14120840

Kocasoy EO, Atmaca MM, Atmaca M, Hanağasi HA. Chorea-Ballismus Associated with Hyperglycemia. Noro psikiyatri arsivi; 2013. Dec;50(4):375-8.

DOI: 10.4274/npa.y6468

Alarcón F, Zijlmans JC, Dueñas G, Cevallos N. Post-stroke movement disorders: Report of 56 patients. J Neurol Neurosurg Psychiatr; 2004. 75: 1568-1574. DOI: 10.1136/jnnp.2003.011874

Borensztein A, Walker RH, Schell R, Guber HA. Hyperglycemia-induced involuntary movements: 2 case reports and a review of the literature. AACE Clinical Case Reports; 2015. Jun;1(3):e165-9

Wagner B, Fuhr P, De Marchis GM. Hemichorea-hemiballism after acute ischemic stroke. Academia Journal of Stroke; 2019. Aug 9;1(1). Avalaible from: https://wrightacademia.org/articles/ajs/ajs-1-003.pdf

Guo TY, Kuo CC, Chen MH, Lin CI, Chan JS, Hsiao PJ, Shyu HY. Comparison of hemichorea-hemiballism between acute stroke and nonketotic-hyperglycinemia in the clinical scenario: Report of a rare diabetic complication. International Archives of Medicine; 2019. Mar 17;12

Chang X, Hong W, Yu H, Yao Y. Chorea associated with nonketotic hyperglycemia: A case report with atypical imaging changes. Medicine; 2017. Nov;96(45). DOI: 10.1097/MD.0000000000008602

Ren-Shi Xu. Pathogenesis of diabetic cerebral vascular disease complication. World J Diabetes; 2015. 6(1): 54-66. DOI: 10.4239/wjd.v6.i1.54

Handley A, Medcalf P, Hellier K, Dutta D. Movement disorders after stroke. Age Ageing; 2009. 38(3): 260-6.

DOI: https://doi.org/10.1093/ageing/afp020

McCullen MK, Miller J, Jabbour S, Furlong K, Shirodakar M, Ahmed I, Mandel S. Chorea in the setting of hyperglycemia: A case report and review of the literature. Pract Neurol; 2010. Mar;16-9. Avalaible form: https://practicalneurology.com/articles/2010-mar-apr/expert-opinion-chorea-in-the-setting-of-hyperglycemia--a-case-report-and-review-of-the-literature

Midi I, Çalişkan HG, Toktaş Z, Sav A, Guenal DI. Generalized choreoathetosis in an acquired immune deficiency syndrome patient with cerebral toxoplasmosis. Turkish Journal of Medical Sciences; 2008. Jul 16;38(4):377-80

Rabhi S, Amrani K, Maaroufi M, Khammar Z, Khibri H, Ouazzani M, Berrady R, Tizniti S, Messouak O, Belahsen F, Bono W. Hemichorea-hemiballismus as an initial manifestation in a Moroccan patient with acquired immunodeficiency syndrome and toxoplasma infection: A case report and review of the literature. Pan African Medical Journal; 2011.10.

DOI: 10.4314/pamj.v10i0.72216

Tse W, Cersosimo MG, Gracies JM, Morgello S, Olanow CW, Koller W. Movement disorders and AIDS: A review. Parkinsonism Relat Disord; 2004. 10:323-34. DOI: 10.1016/j.parkreldis.2004.03.001

Ohara S. Diabetic Hemichorea-hemiballism. Austin J Clin Neurol; 2015. 2(4):1-6. Avalaible form: https://austinpublishinggroup.com/clinical-neurology/fulltext/ajcn-v2-id1037.php

Bashir H, Jankovic J. Treatment options for chorea. Expert Review of Neurotherapeutics; 2018 Jan 2;18(1):51-63.

DOI: https://doi.org/10.1080/14737175.2018.1403899

Reich, Stephen G, Stewart A. Factor. Therapy of movement disorders a case-based approach. Humana Press. USA; 2019.

Herath HM, Pahalagamage SP, Senanayake S. Case report of hyperglycemic nonketotic chorea with rapid radiological resolution. BMC Medical Imaging; 2017. Dec 1;17(1):54. Avalaible from: https://bmcmedimaging.biomedcentral.com/articles/10.1186/s12880-017-0228-2


Refbacks

  • There are currently no refbacks.