Nonketotic Hyperglycemic Chorea-Ballism (NKHCB): An Atypical Case and a Review of Literature

Abstract

Nonketotic hyperglycemic chorea-ballism (NKHCB) is a rare movement disorder characterized by hemichoreahemiballism, contralateral striatal abnormality, and rapid resolution following glycemic control. We describe an atypical case of NKHCB in a 71-year-old female with uncontrolled type 2 diabetes exhibiting hemichorea and hemiballism limited to the right upper extremity. While NKHCB patients typically show abnormalities on computed tomography (CT) imaging of the head, a CT scan of our patient during the acute phase was unremarkable. The movements subsided following glycemic control and fluid administration. The current literature on NKHCB is sparse and largely limited to case reports and series. We discuss several typical and atypical presentations and findings on imaging.