Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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March 2, 2009
Hyperglycemia-induced Hemiballism-hemichorea
- Usually due to nonketotic hyperglycemia secondary to diabetes mellitus, blood sugar levels generally above 200 mg/dl
- Good prognosis with treatment of diabetes
- Generally unilateral affecting caudate nucleus and putamen, hyperdense on non-contrast CT, high T1, some contrast enhancement, T2 images may be normal or show subtle high or low signal, MRS shows high lactate and low Cr
- Causes of MR abnormalities: presence of gemistocytes, microbleeds, calcium, demyelination, macrophages
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