Title : Case report: Neuroimaging changes of nonketotic hyperglycemia chorea patient with status epilepticus attack
Abstract:
Background: We present the neuroimaging findings of case of non-ketotic hyperglycemia (NKH) associated with seizures and chorea. Seizures of NKH patients are usually focal motor seizures, rarely progress to status epilepticus with secondary generalization.
Case Presentation: An eighty-three-year-old male came to emergency department with seizure. He also had been suffered abnormal movement like chorea for 2-3weeks. He had been diagnosed with diabetes mellitus, but was not on proper treatment for recent several weeks. Random blood sugar was 532 mg/dl. Arterial blood gas showed mild acidosis (pH 7.31) and ketone bodies were not detected in urine. Non-contrast computerized Tomography brain on day 1 showed left side hyperdense lentiform and caudate nuclei. Diffusion & SWI MRI on day 1 showed focal abnormal signal intensity of left side basal ganglia. He was started on insulin and valproic acid at ER. He was transferred to other hospital for glycemic control. Five days later, He revisited our hospital due to uncontrolled seizure with unconsciousness. CT was repeated on day 6, 18 and MRI was done on day 7, 35 after glycemic control. Patient recovered clinically well and showed rapid radiological resolution, too.
Conclusion: We show rare NKH patient having seizure and chorea with serial imaging study.
