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  • Title: Encephalopathy, hypoglycemia, and flailing extremities: a case of bilateral chorea-ballism associated with diabetic ketoacidosis.
    Author: Guerrero WR, Okun MS, McFarland NR.
    Journal: Tremor Other Hyperkinet Mov (N Y); 2012; 2():. PubMed ID: 23439397.
    Abstract:
    BACKGROUND: Hypo/hyperglycemia is a known cause of chorea and hemiballism. The temporallobes, hippocampus, basal ganglia, and substantia nigra are most susceptible to hypoglycemic changes. METHODS: We present a caseof bilateral chorea and bi-ballism accompanied by encephalopathyin the setting of severe hypoglycemia and diabetic ketoacidosis. The patient had brain MRI changes involving both caudate nuclei, temporal lobes, and hippocampi. DISCUSSION: This case demonstrates the basal ganglia's vulnerability to hypoglycemia and the need for cautious evaluation of involuntary movements when they occur in the setting of encephalopathy.
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