Hemichorea-Hemiballism in Hyperosmolar Hyperglycemic State: A Rare Presentation

Hemichorea-hemiballism is a syndrome of involuntary movement in one side of the body because of a process in basal ganglia. This condition considered as a rare presentation in hyperglycemic hyperosmolar state. Knowledge about this syndrome can lead to better management of the disease. We present a case of a-52 year old woman with the complaint of involuntary movement on her right upper and lower extremities, since four hours before admission. The patient was diagnosed with diabetes mellitus type 2 on oral anti diabetic but didn’t take her medicine in the last 2 months. Blood glucose control achieved after 11 days of hospitalization. The involuntary movement ceased on the 17th day. This case shows hyperglycemic hyperosmolar state with hemichorea-hemiballismus as one of the complication. The involuntary movement stopped few days after good blood glucose control. The fluctuation of the blood glucose is to be expected because of the complicated nature of the diagnosis and comorbidity in our patient.