METHODS: A 58-year-old Tanzanian chagga by tribe with a body mass index of 28 kg/m(2) and newly diagnosed type II diabetes presented with polydipsia and involuntary movements of the right upper limb for 4 days. His plasma glucose was 549 mg/dl and glycated haemoglobin was 18.9 %. His movements were exaggerated by attempts to use his right hand. The rest of his neurological assessment was unremarkable. Other laboratory findings including calcium were within the normal range. A computed tomography scan of the brain was essentially normal except for age-related atrophy. There was no significant ketonuria on urine dipstick testing. We treated the patient\'s hyperglycaemia with intravenous insulin and the dystonia disappeared within 5 days.
CONCLUSIONS: Hemichorea is among the rare complications of hyperglycaemia-induced involuntary movements. Hyperglycaemia should be considered as a differential diagnosis for patients with type II diabetes mellitus presenting with hemichorea upon clinical assessment.
方法:一个58岁的坦桑尼亚chagga,按部落划分,体重指数为28kg/m(2),新诊断的II型糖尿病,表现为多饮和右上肢不自主运动4天。他的血浆葡萄糖为549mg/dl,糖化血红蛋白为18.9%。他的动作因试图使用右手而被夸大了。他的其余神经学评估并不引人注目。包括钙在内的其他实验室检查结果均在正常范围内。除了与年龄相关的萎缩外,大脑的计算机断层扫描基本正常。在尿液试纸测试中没有明显的酮尿症。我们用静脉注射胰岛素治疗患者的高血糖症,肌张力障碍在5天内消失。
结论:偏球症是高血糖引起的不自主运动的罕见并发症之一。经临床评估,高血糖应被视为II型糖尿病患者的鉴别诊断。