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Review • Arch. Endocrinol. Metab. 68 • 2024 • https://doi.org/10.20945/2359-4292-2022-0413   copy

Hyperglycemia-induced hemichorea-hemiballismus syndrome – a systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Nonketotic hyperglycemia may occur as a cause of chorea in patients with chronic decompensated diabetes. Because it is rare and consequently poorly studied, diagnosis and treatment can be delayed. Therefore, our objective was to summarize clinical and radiological features, as well as treatments performed, from previously reported cases to facilitate adequate management in clinical practice. We searched MEDLINE/PubMed, EMBASE, Cochrane, CINAHL, Web of Science, Scopus, and LILACS databases for studies published before April 23, 2021. We included case reports and case series of adults (aged ≥ 18 years) that described hyperglycemic chorea with measurement of glycated hemoglobin (HbA1c) and cranial magnetic resonance imaging (MRI). Studies were excluded if participants were pregnant women, aged < 18 years, and had no description of chorea and/or physical examination. We found 121 studies that met the inclusion criteria, for a total of 214 cases. The majority of the included studies were published in Asia (67.3%). Most patients were women (65.3%) aged > 65 years (67.3%). Almost all patients had decompensated diabetes upon arrival at the emergency department (97.2%). The most common MRI finding was abnormalities of the basal ganglia (89.2%). There was no difference in patient recovery between treatment with insulin alone and in combination with other medications. Although rare, hyperglycemic chorea is a reversible cause of this syndrome; therefore, hyperglycemia should always be considered in these cases.

INTRODUCTION

Chorea, from the Greek word choros, means dance. It is a neurological disorder associated with involuntary spasmodic muscle movements. Nonketotic hyperglycemia is a rare cause of chorea. In 1960, Bedwell described the first case of severe hyperglycemia associated with hemiballismus, which resolved with correction of blood glucose (11 Bedwell SF. Some observations on hemiballismus. Neurology. 1960 Jun:10:619-22. doi: 10.1212/wnl.10.6.619.
https://doi.org/10.1212/wnl.10.6.619... ).

Typically, hyperglycemic chorea occurs in Asian women with long-standing type 2 diabetes and chronic poor glycemic control. Cranial magnetic resonance imaging (MRI) shows a characteristic T1 hyperintensity signal in the basal ganglia (22 Xiao F, Liu M, Wang X. Involuntary choreiform movements in a diabetic patient. Lancet. 2019 Mar;393(10175):1033. doi: 10.1016/S0140-6736(19)30304-6.
https://doi.org/10.1016/S0140-6736(19)30... ). A recent systematic review identified 176 patients from 72 articles, of whom only 17% had newly diagnosed diabetes mellitus at first presentation (33 Chua CB, Sun CK, Hsu CW, Tai YC, Liang CY, Tsai IT. "Diabetic striatopathy": clinical presentations, controversy, pathogenesis, treatments, and outcomes. Sci Rep. 2020 Jan 31;10(1):1594. doi: 10.1038/s41598-020-58555-w.
https://doi.org/10.1038/s41598-020-58555... ). Another systematic review evaluated 286 patients from 136 studies and showed that 63% were women, 100% received hypoglycemic drugs, 60.84% received neuroleptics, and 84.86% showed complete resolution (44 Gómez-Ochoa SA, Espín-Chico BB, Pinilla-Monsalve GD, Kaas BM, Téllez-Mosquera LE. Clinical and neuroimaging spectrum of hyperglycemia-associated chorea-ballism: systematic review and exploratory analysis of case reports. Funct Neurol. 2018 Oct/Dec;33(4):175-87.). It is not clear whether there is any standard or specific treatment for cases of chorea associated with hyperglycemia, both regarding the prescription of anticonvulsants and regarding the prescription of insulin alone or in combination with other antihyperglycemic drugs (33 Chua CB, Sun CK, Hsu CW, Tai YC, Liang CY, Tsai IT. "Diabetic striatopathy": clinical presentations, controversy, pathogenesis, treatments, and outcomes. Sci Rep. 2020 Jan 31;10(1):1594. doi: 10.1038/s41598-020-58555-w.
https://doi.org/10.1038/s41598-020-58555... ,55 Oh SH, Lee KY, Im JH, Lee MS. Chorea associated with non-ketotic hyperglycemia and hyperintensity basal ganglia lesion on T1-weighted brain MRI study: a meta-analysis of 53 cases including four present cases. J Neurol Sci. 2002 Aug 15;200(1-2):57-62. doi: 10.1016/s0022-510x(02)00133-8.
https://doi.org/10.1016/s0022-510x(02)00... ).

We report the case of a patient diagnosed with diabetes mellitus at presentation with hyperglycemia-induced hemichorea-hemiballismus syndrome. We also conducted a systematic review of clinical and radiological features, treatment, and prognosis.

MATERIALS AND METHODS

Information sources

We searched MEDLINE/PubMed, EMBASE, Cochrane, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Scopus, and LILACS databases for articles published from inception to April 23, 2021. We set no language restrictions. A research librarian developed the search strategy. Our search did not include any gray literature. The complete search strategy is provided in Table 1.

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Table 1
Search strategies

Study selection

The results of the database searches were compiled using Rayyan software, and two reviewers (MH and VW) independently screened titles and abstracts using a standardized form for data extraction, and then screened candidate full-text articles for selection based on our inclusion and exclusion criteria. Full texts of all potential studies for inclusion were retrieved and independently assessed by other two reviewers (PB and VB). Any disagreements between reviewers at any stage were resolved by consulting a third independent reviewer (RPB).

Studies eligible for inclusion in this review were case reports and case series of adults (aged ≥ 18 years) that described hyperglycemic chorea with measurement of glycated hemoglobin (HbA1c) and cranial MRI. Studies were excluded if participants were pregnant women, aged < 18 years, and had no description of chorea and/or physical examination. If articles were not available, we contacted the corresponding authors. Decompensated diabetes was defined as HbA1c > 8% or capillary blood glucose > 200 mg/dL.

For studies meeting eligibility, data extracted included age of patient(s), laboratory and clinical data, MRI findings, treatment performed, type of diabetes, time from diagnosis, and study country. The flowchart of studies selection process is summarized in figure 1.

Figure 1
Flow diagram: Identification and selection of articles

Data analysis

Narrative and quantitative syntheses were performed to describe the results. Data were analyzed in SPSS. Parametric data were presented as mean (SD), and nonparametric data as median (IQR). P values of less than 0.05 and 95% CIs were considered statistically significant.

RESULTS

Case report

A 62-year-old female patient was seen in the emergency department of a tertiary care hospital reporting that two days ago she started walking unsteadily and one day ago she presented uncoordinated and involuntary left hemi body movements with progressive worsening, maintaining a preserved level of consciousness. In addition, dysarthria and tremors appeared in the left hemiface. She reported a history of pre-diabetes for four years, and was taking metformin (850 mg twice a day) with no recent medical follow-up. She also presented systemic arterial hypertension and atrial fibrillation, both under treatment. Upon arrival, she was alert, oriented, sweating, capillary blood glucose was 136 mg/dL, heart rate (HR) was 140-160 bpm, normal cardiac and pulmonary auscultations, no abnormality in the abdominal exam. Intravenous diazepam 5 mg was administered with improvement. Initial laboratory tests revealed glycemia 127 mg/dL, creatinine 1.11 mg/dL (glomerular filtration rate 53 mL/min/1.73 m2), bicarbonate 16 mEq/L (reference value: 23-31 mEq/L), sodium 146 mEq/L (reference value:136-145 mEq/L), potassium 4.3 mEq/L (reference value: 3.5-5.1 mEq/L), calcium 10 mg/dL (reference value: 8.4-10.2 mg/dL), hemoglobin 12.4. Serologies for HIV, hepatitis C, hepatitis B and syphilis were all negative. Brain CT showed areas of increased attenuation in the striated bodies, suggesting the possibility of non-ketotic hyperglycemia as the cause of the symptoms, with no visible expansive lesion or intracranial collections. A lumbar puncture was performed with cerebrospinal fluid showing 1 leukocyte/uL (reference value: up to 5/uL), no germs, protein 29.6 mg/dL (reference value: up to 40 mg/dL). Electrocardiogram showed atrial fibrillation. The patient underwent brain MRI with intravenous injection of gadolinium contrast, demonstrating T1 hypersignal with a component of hypo signal in T2/FLAIR. Glycated hemoglobin (HbA1c) was also evaluated, which was 12.7% (reference value: < 5.7%). During hospitalization she was started on risperidone 2 mg twice a day, with progressive improvement of motor symptoms, later reduced to 1 mg twice a day. Metformin was also adjusted to 1,000 mg twice a day and NPH insulin was introduced twice a day, 14 IU before breakfast and 10 IU at 10 pm. Patient returned to the outpatient clinic two months after hospital discharge, reporting no symptoms, with no recurrence of hemichorea. She maintained good adherence to the treatment, presenting HbA1c 8.2%.

Literature review

The initial search yielded 774 records, 547 of which remained after adjusting for duplicates. After title and abstract screening, 249 studies were retrieved for full-text review, 118 of which met the inclusion criteria. Another 3 full-text articles cited in the initially screened texts were considered eligible, bringing the total number of included studies to 121, for a total of 214 cases.

Table 2 shows the characteristics of patients in the reported cases, according to sex. Most patients were women (65.3%). The median age was 71 years, and 67.3% were over 65 years of age. The majority of the included studies were published in Asia (67.3%), with South Korea being the country with the largest number of reported cases (n = 45). Almost all patients had decompensated diabetes (97.2%) on hospital arrival, and in 22% of them the diagnosis was made when the patient presented to the emergency department with chorea. The most common MRI finding was abnormalities of the basal ganglia (89.2%), with only 5.2% of cases with normal MRI.

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Table 2
Characteristics of the participants of the included studies according to sex (n = 214)

Regarding publication dates, there was an increase in reports in recent years: 5 case reports were published from 1994 to 2000, 25 from 2001 to 2010, 90 from 2011 to 2020, and 2 in 2021, in addition to the present case report.

Regarding patient recovery, there was no difference between treatment with insulin alone and in combination with other medications (p 1.0). Also, no difference was found between insulin alone and insulin with haloperidol, insulin with haloperidol and benzodiazepine, or insulin with benzodiazepine (p 0.358).

DISCUSSION

Nonketotic hyperglycemic hemichorea is a poorly recognized entity, with few studies and a probably underestimated incidence. In the last two decades, the prevalence of adults with diabetes has increased from 4.6% to 10.5% of the global population (66 Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019 Nov;157:107843. doi: 10.1016/j.diabres.2019.107843.
https://doi.org/10.1016/j.diabres.2019.1... ). Likewise, there has been an increase in reports of hyperglycemic chorea published over the years. However, whether the number of diagnoses has increased or cases are just being increasingly recognized and reported remains unclear.

In our study, 61 patients (22%) presented with symptoms of chorea as the first presentation of diabetes. This is interesting as it indicates that hyperglycemia should always be suspected in these cases. A recent study showed similar data: 17% of chorea cases also had newly diagnosed diabetes (33 Chua CB, Sun CK, Hsu CW, Tai YC, Liang CY, Tsai IT. "Diabetic striatopathy": clinical presentations, controversy, pathogenesis, treatments, and outcomes. Sci Rep. 2020 Jan 31;10(1):1594. doi: 10.1038/s41598-020-58555-w.
https://doi.org/10.1038/s41598-020-58555... ).

It is known that long-term complications of diabetes, both microvascular and macrovascular, are more common in people with long-standing poor glycemic control (77 Rawshani A, Rawshani A, Franzén S, Sattar N, Eliasson B, Svensson AM, et al. Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2018 Aug 16;379(7):633-644. doi: 10.1056/NEJMoa1800256.
https://doi.org/10.1056/NEJMoa1800256... ). Although chorea cannot be considered a complication of diabetes, we observed that, regarding glycemic control, 97% of the cases in which the two conditions were associated had blood glucose levels > 200 mg/dL or HbA1c > 8% (55 Oh SH, Lee KY, Im JH, Lee MS. Chorea associated with non-ketotic hyperglycemia and hyperintensity basal ganglia lesion on T1-weighted brain MRI study: a meta-analysis of 53 cases including four present cases. J Neurol Sci. 2002 Aug 15;200(1-2):57-62. doi: 10.1016/s0022-510x(02)00133-8.
https://doi.org/10.1016/s0022-510x(02)00... ,88 Cho HS, Hong CT, Chan L. Hemichorea after hyperglycemia correction: A case report and a short review of hyperglycemia-related hemichorea at the euglycemic state. Medicine (Baltimore). 2018 Mar;97(10):e0076. doi: 10.1097/MD.0000000000010076.
https://doi.org/10.1097/MD.0000000000010... ). Although the exact mechanism of chorea associated with hyperglycemia and/or diabetes is unknown, in hyperglycemia, the brain metabolism is known to shift to anaerobic pathways, with inactivation of Krebs cycle. In this setting, new substrates are used by the brain, such as gamma-aminobutyric acid (GABA), which may be involved in the genesis of basal ganglia dysfunction and result in disinhibition of the subthalamus and basal ganglia, thus leading to the involuntary movements characteristic of chorea (99 Guisado R, Arieff AI. Neurologic manifestations of diabetic comas: Correlation with biochemical alterations in the brain. Metabolism. 1975 May;24(5):665-79. doi: 10.1016/0026-0495(75)90146-8.
https://doi.org/10.1016/0026-0495(75)901... ). However, this hypothesis does not consider circumstances where hyperglycemia is corrected but clinical symptoms are not quickly reversed or even worsen. This may occur by a mechanism similar to that of diabetic retinopathy that worsens with rapid normalization of blood glucose levels (1010 Abe Y, Yamamoto T, Soeda T, Kumagai T, Tanno Y, Kubo J, et al. Diabetic Striatal Disease: Clinical Presentation, Neuroimaging, and Pathology. Intern Med. 2009;48(13):1135-41. doi: 10.2169/internalmedicine.48.1996.
https://doi.org/10.2169/internalmedicine... ).

Most reports included in this review describe patients from Asian countries, consistent with the literature (55 Oh SH, Lee KY, Im JH, Lee MS. Chorea associated with non-ketotic hyperglycemia and hyperintensity basal ganglia lesion on T1-weighted brain MRI study: a meta-analysis of 53 cases including four present cases. J Neurol Sci. 2002 Aug 15;200(1-2):57-62. doi: 10.1016/s0022-510x(02)00133-8.
https://doi.org/10.1016/s0022-510x(02)00... ,1111 Lin JJ, Lin GY, Shih C, Shen WC. Presentation of striatal hyperintensity on T1-weighted MRI in patients with hemiballism-hemichorea caused by non-ketotic hyperglycemia: Report of seven new cases and a review of literature. J Neurol. 2001 Sep;248(9):750-5. doi: 10.1007/s004150170089.
https://doi.org/10.1007/s004150170089... ,1212 Wang W, Tang X, Feng H, Sun F, Liu L, Rajah GB, et al. Clinical manifestation of non-ketotic hyperglycemia chorea: A case report and literature review. Medicine (Baltimore). 2020 May 29;99(22):e19801. doi: 10.1097/MD.0000000000019801.
https://doi.org/10.1097/MD.0000000000019... ). However, such data may be due only to reporting bias. There are no clear data in the literature with appropriate genetic analyses linking the occurrence of chorea associated with hyperglycemia to genetic or family profiles.

Diabetes is estimated to affect more than 500 million adults aged 20-79 years worldwide (1313 Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022 Jan;183:109119. doi: 10.1016/j.diabres.2021.109119.
https://doi.org/10.1016/j.diabres.2021.1... ), affecting non-Hispanic whites in 7.1% of cases, Asian Americans in 8.4%, Hispanic Americans in 11.8%, non-Hispanic blacks in 12.6%, and Native Americans in 33% (1414 Spanakis EK, Golden SH. Race/Ethnic Difference in Diabetes and Diabetic Complications. Curr Diab Rep. 2013 Dec;13(6):814-23. doi: 10.1007/s11892-013-0421-9.
https://doi.org/10.1007/s11892-013-0421-... ). The prevalence of diabetes is similar in men and women, being higher in those aged 75-79 years (1313 Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022 Jan;183:109119. doi: 10.1016/j.diabres.2021.109119.
https://doi.org/10.1016/j.diabres.2021.1... ). Regarding complications, women with diabetes, especially postmenopausal women, tend to be at higher cardiovascular risk than men with diabetes in the same age group (1515 Seghieri G, Policardo L, Anichini R, Franconi F, Campesi I, Cherchi S, et al. The Effect of Sex and Gender on Diabetic Complications. Curr Diabetes Rev. 2017;13(2):148-60. doi: 10.2174/1573399812666160517115756.
https://doi.org/10.2174/1573399812666160... ). In line with this, our study showed a higher prevalence of chorea in older women, data similar to those reported in the literature (33 Chua CB, Sun CK, Hsu CW, Tai YC, Liang CY, Tsai IT. "Diabetic striatopathy": clinical presentations, controversy, pathogenesis, treatments, and outcomes. Sci Rep. 2020 Jan 31;10(1):1594. doi: 10.1038/s41598-020-58555-w.
https://doi.org/10.1038/s41598-020-58555... ,55 Oh SH, Lee KY, Im JH, Lee MS. Chorea associated with non-ketotic hyperglycemia and hyperintensity basal ganglia lesion on T1-weighted brain MRI study: a meta-analysis of 53 cases including four present cases. J Neurol Sci. 2002 Aug 15;200(1-2):57-62. doi: 10.1016/s0022-510x(02)00133-8.
https://doi.org/10.1016/s0022-510x(02)00... ).

Population aging leads to a larger number of neurodegenerative disorders due to the accumulation of nuclear DNA (nDNA) damage to neurons in the cerebral cortex and hippocampus, as well as oxidative damage to biomolecules that lead to a chronic inflammatory response (1616 GBD 2017 US Neurological Disorders Collaborators; Feigin VL, Vos T, Alahdab F, Amit AML, Bärnighausen TW, Beghi E, et al. Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study. JAMA Neurol. 2021 Feb 1;78(2):165-76. doi: 10.1001/jamaneurol.2020.4152.
https://doi.org/10.1001/jamaneurol.2020.... ). Considering all these factors, we can infer that older patients with diabetes are even more likely to develop diabetes-related neurological complications, including hyperglycemic chorea.

In conclusion, recognizing this rare complication of diabetes is important, as early diagnosis and management will result in resolution of symptoms and better outcomes, avoiding unnecessary investigations.

REFERENCES

  • 1
    Bedwell SF. Some observations on hemiballismus. Neurology. 1960 Jun:10:619-22. doi: 10.1212/wnl.10.6.619.
    » https://doi.org/10.1212/wnl.10.6.619
  • 2
    Xiao F, Liu M, Wang X. Involuntary choreiform movements in a diabetic patient. Lancet. 2019 Mar;393(10175):1033. doi: 10.1016/S0140-6736(19)30304-6.
    » https://doi.org/10.1016/S0140-6736(19)30304-6
  • 3
    Chua CB, Sun CK, Hsu CW, Tai YC, Liang CY, Tsai IT. "Diabetic striatopathy": clinical presentations, controversy, pathogenesis, treatments, and outcomes. Sci Rep. 2020 Jan 31;10(1):1594. doi: 10.1038/s41598-020-58555-w.
    » https://doi.org/10.1038/s41598-020-58555-w
  • 4
    Gómez-Ochoa SA, Espín-Chico BB, Pinilla-Monsalve GD, Kaas BM, Téllez-Mosquera LE. Clinical and neuroimaging spectrum of hyperglycemia-associated chorea-ballism: systematic review and exploratory analysis of case reports. Funct Neurol. 2018 Oct/Dec;33(4):175-87.
  • 5
    Oh SH, Lee KY, Im JH, Lee MS. Chorea associated with non-ketotic hyperglycemia and hyperintensity basal ganglia lesion on T1-weighted brain MRI study: a meta-analysis of 53 cases including four present cases. J Neurol Sci. 2002 Aug 15;200(1-2):57-62. doi: 10.1016/s0022-510x(02)00133-8.
    » https://doi.org/10.1016/s0022-510x(02)00133-8
  • 6
    Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019 Nov;157:107843. doi: 10.1016/j.diabres.2019.107843.
    » https://doi.org/10.1016/j.diabres.2019.107843
  • 7
    Rawshani A, Rawshani A, Franzén S, Sattar N, Eliasson B, Svensson AM, et al. Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2018 Aug 16;379(7):633-644. doi: 10.1056/NEJMoa1800256.
    » https://doi.org/10.1056/NEJMoa1800256
  • 8
    Cho HS, Hong CT, Chan L. Hemichorea after hyperglycemia correction: A case report and a short review of hyperglycemia-related hemichorea at the euglycemic state. Medicine (Baltimore). 2018 Mar;97(10):e0076. doi: 10.1097/MD.0000000000010076.
    » https://doi.org/10.1097/MD.0000000000010076
  • 9
    Guisado R, Arieff AI. Neurologic manifestations of diabetic comas: Correlation with biochemical alterations in the brain. Metabolism. 1975 May;24(5):665-79. doi: 10.1016/0026-0495(75)90146-8.
    » https://doi.org/10.1016/0026-0495(75)90146-8
  • 10
    Abe Y, Yamamoto T, Soeda T, Kumagai T, Tanno Y, Kubo J, et al. Diabetic Striatal Disease: Clinical Presentation, Neuroimaging, and Pathology. Intern Med. 2009;48(13):1135-41. doi: 10.2169/internalmedicine.48.1996.
    » https://doi.org/10.2169/internalmedicine.48.1996
  • 11
    Lin JJ, Lin GY, Shih C, Shen WC. Presentation of striatal hyperintensity on T1-weighted MRI in patients with hemiballism-hemichorea caused by non-ketotic hyperglycemia: Report of seven new cases and a review of literature. J Neurol. 2001 Sep;248(9):750-5. doi: 10.1007/s004150170089.
    » https://doi.org/10.1007/s004150170089
  • 12
    Wang W, Tang X, Feng H, Sun F, Liu L, Rajah GB, et al. Clinical manifestation of non-ketotic hyperglycemia chorea: A case report and literature review. Medicine (Baltimore). 2020 May 29;99(22):e19801. doi: 10.1097/MD.0000000000019801.
    » https://doi.org/10.1097/MD.0000000000019801
  • 13
    Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022 Jan;183:109119. doi: 10.1016/j.diabres.2021.109119.
    » https://doi.org/10.1016/j.diabres.2021.109119
  • 14
    Spanakis EK, Golden SH. Race/Ethnic Difference in Diabetes and Diabetic Complications. Curr Diab Rep. 2013 Dec;13(6):814-23. doi: 10.1007/s11892-013-0421-9.
    » https://doi.org/10.1007/s11892-013-0421-9
  • 15
    Seghieri G, Policardo L, Anichini R, Franconi F, Campesi I, Cherchi S, et al. The Effect of Sex and Gender on Diabetic Complications. Curr Diabetes Rev. 2017;13(2):148-60. doi: 10.2174/1573399812666160517115756.
    » https://doi.org/10.2174/1573399812666160517115756
  • 16
    GBD 2017 US Neurological Disorders Collaborators; Feigin VL, Vos T, Alahdab F, Amit AML, Bärnighausen TW, Beghi E, et al. Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study. JAMA Neurol. 2021 Feb 1;78(2):165-76. doi: 10.1001/jamaneurol.2020.4152.
    » https://doi.org/10.1001/jamaneurol.2020.4152

SUPPLEMENTARY MATERIAL

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AUTHOR Year Gender Age Country Glucose HbA1c Clinical presentation Site of change on MRI Chorea treatment Recovery Recurrence Diabetes Diagnosis Diabetes Type Diabetes Duration Abdelghany, M 2014 M 34 USA 230 13,6 Hemichorea Basal ganglia Ins + other Y N Y T2DM N.I. Abe, Y Case 1 2009 F 72 Japan 130 6,2 Hemichorea Basal ganglia ins + hal Y N Y T2DM <5 years Case 2 2009 M 73 Japan 151 17,2 Hemichorea Basal ganglia ins + hal Y N Y N.S. N.I. Case 3 2009 F 68 Japan 118 6,5 Hemichorea Basal ganglia ins + hal Y N N - - Case 4 2009 M 56 Japan 161 8 Other Basal ganglia Insulin N.I. N.I. Y N.S. N.I. Case 5 2009 F 84 Japan 107 7,4 Hemichorea Basal ganglia ins + hal Y N Y N.S. 5-10 years Abou-Al-Shaar, H 2018 M 59 USA 351 8,4 Other Basal ganglia Ins + Other Y N Y T2DM <5 years Acuna, MJV 2016 M 72 USA 873 13,2 Hemichorea Normal Insulin Y N N - - Ahmad, A 2013 F 63 Singapore 522 16,7 Hemichorea Basal ganglia Insulin Y N Y T2DM N.I. Ahmad, S 2018 F 83 UK 540 14,1 Hemichorea Basal ganglia Insulin Y N Y T2DM N.I. Al-Quliti, KW 2016 F 58 Saudi Arabia 540 13,5 Hemichorea Basal ganglia Ins + hal + bdz Y N Y N.S. >10 years Ari, BC 2021 F 67 Turkey 999 14 Hemichorea Normal ins + hal Y N Y T2DM >10 years Arriaga, AC Case 1 2009 M 70 Mexico 202 15,4 Chorea Basal ganglia Ins + hal + bdz Y Y N - - Case 2 2009 F 81 Mexico 375 5,6 Hemichorea Basal ganglia ins + hal Y N N - - Atay, M Case 1 2014 F 79 Turkey 254 11 Hemichorea Basal ganglia Insulin Y N Y T2DM N.I. Case 2 2014 F 75 Turkey 564 14,4 Hemichorea Basal ganglia Insulin Y N Y N.S. N.I. Awasthi, D 2012 F 21 USA 535 18,4 Hemichorea Basal ganglia Insulin Y N N - - Battist,i C Case 1 2009 F 80 Italy 500 8 Hemichorea Basal ganglia ins + hal P - N - - Case 2 2009 F 78 Italy 463 10 Hemichorea Basal ganglia ins + hal Y N N - - Bendi, VS 2018 M 68 USA 1160 13,8 Chorea Basal ganglia ins + bdz P - Y T2DM N.I. Bhagwat, NM 2013 F 71 India 650 13,5 Hemichorea Normal Ins + Other Y N Y T2DM 5-10 years Billich, C 2015 M 75 Germany 320 8,3 Hemichorea Basal ganglia Ins + Other Y N Y T2DM <5 years Bizet, J 2014 F 66 USA 984 12,2 Hemichorea Basal ganglia ins + hal Y N Y T2DM N.I. Buysschaert, M 2011 F 81 Belgium 609 15,3 Hemichorea Basal ganglia Insulin Y N N - - Carrion, DM 2013 M 52 Ecuador 451 10,8 Hemichorea Basal ganglia Insulin Y Y N - - Castro, DM 2009 M 73 Argentina 107 8,5 Hemichorea Basal ganglia ins + bdz Y N Y T2DM <5 years Chalia, M 2019 M 60 USA 159 14,1 Hemichorea Basal ganglia Ins + Other Y N Y T2DM >10 years Chang, CV 2007 M 66 Brazil 588 13,9 Hemichorea Basal ganglia ins + hal Y N N - - Chang, X 2017 F 84 China 669 14 Chorea Basal ganglia Ins + Other Y N Y T2DM >10 years Cheema, H 2011 F 91 Australia 756 16,1 Hemichorea Basal ganglia Insulin P - Y T2DM N.I. Chen, H 2017 M 69 Taiwan 533 10,4 Other Normal Insulin Y N Y T2DM N.I. Cherian, A 2009 F 50 EUA 421 17,7 Hemichorea Basal ganglia Ins + hal + bdz Y N N - - Cho, HS 2018 M 70 Taiwan 415 19 Hemichorea Normal ins + hal Y N N.I. N.I. N.I. Chu, K Case 1 2002 F 69 Korea 348 9,5 Hemichorea Basal ganglia Ins + other Y N Y N.S. 5-10 years Case 2 2002 F 62 Korea 370 9,7 Hemichorea Basal ganglia ins + hal Y N Y N.S. <5 years Chung, SJ 2005 F 78 Korea 473 18 Hemichorea Basal ganglia ins + bdz Y N Y T2DM 5-10 years D'Angelo, R 2013 M 41 Italy 174 14 Chorea Basal ganglia Ins + hal + bdz Y N N - - Das, L Case 1 2016 M 18 India 553 16,2 Hemichorea Basal ganglia Ins + other Y N Y T1DM 5-10 years Case 2 2016 M 21 India 645 15,8 Hemichorea Basal ganglia ins + hal Y N Y T1DM <5 years Fatima,M 2020 M 30 N.I. 453 15,13 Hemichorea Basal ganglia ins + hal Y N N - - Fei Xiao 2019 F 62 China 320 13,6 Hemichorea Basal ganglia Ins + hal + bdz P - Y T2DM 5-10 years Felicio, AC Case 1 2014 M 70 Brazil 560 6,6 Hemichorea Basal ganglia ins + hal Y N N - - Case 2 2014 M 66 Brazil 588 13,9 Hemichorea Basal ganglia ins + hal Y N N - - Fong, SL 2019 F 76 Malaysia 558,6 10,5 Hemichorea Basal ganglia Ins + hal + bdz Y N Y N.S. >10 years Gambito, MR 2016 M 77 USA 845 16 Hemichorea Other Ins + other Y N Y T2DM N.I. González, TGP Case 1 2017 F 64 Spain 417 16,5 Hemichorea Basal ganglia ins + bdz Y N Y N.S. N.I. Case 2 2017 F 68 Spain 392 13,8 Hemichorea Basal ganglia Ins + hal + bdz Y N N - - Case 3 2017 F 85 Spain 939 15,7 Chorea Basal ganglia Ins + hal + bdz Y N Y N.S. N.I. Case 4 2017 M 88 Spain 196 16,1 Hemichorea Basal ganglia Ins + hal + bdz Y N N - - Guo, Y Case 1 2014 F 81 China 214 9,3 Hemichorea Normal insulin N.I. N.I. N - - Case 2 2014 F 74 China 180 10,7 Hemichorea Basal ganglia ins + hal N.I. N.I. Y N.S. >10 years Case 3 2014 F 82 China 239 9,5 Hemichorea Basal ganglia ins + hal N.I. N.I. N - - Case 4 2014 F 82 China 504 15,7 Hemichorea Basal ganglia Ins + hal + bdz N.I. N.I. Y N.S. 5-10 years Case 5 2014 F 65 China 380 13,7 Hemichorea Basal ganglia Insulin N.I. N.I. Y N.S. 5-10 years Case 6 2014 M 70 China 355 13,6 Hemichorea Basal ganglia ins + hal N.I. N.I. Y N.S. 5-10 years Case 7 2014 M 74 China 460 12,4 Hemichorea Basal ganglia ins + hal N.I. N.I. Y N.S. <5 years Hashimoto, K 2012 F 40 USA 791 9,5 Chorea Basal ganglia Insulin P - Y DM1 >10 years Hashimoto, T Case 1 1998 M 77 Japan 264 18,7 Hemichorea Basal ganglia ins + hal P - Y N.S. 5-10 years Case 2 2012 F 77 Japan 632 19 Hemichorea Basal ganglia ins + hal S N Y N.S. N.I. Case 3 2012 F 78 Japan 455 14,4 Hemichorea Basal ganglia ins + hal P - Y N.S. N.I. Helmy, A 2019 F 71 France 417 12,4 Hemichorea Basal ganglia Ins + Other P - Y T2DM N.I. Hiesgen, J 2014 M 63 Germany 258 14,4 Hemichorea Basal ganglia Ins + other Y N Y T2DM N.I. Higa, M 2003 F 82 Japan 306 13,2 Hemichorea Basal ganglia Insulin Y N.I. Y T2DM 5-10 years Homaida, M 2021 F 71 UK 360 11,7 Hemichorea Basal ganglia ins + hal Y N Y T2DM N.I. Hsiao PJ 2019 F 39 Taiwan 765 13,4 Hemichorea Basal ganglia ins + bdz Y N Y T2DM N.I. Hussaini, S 2019 M 50 Netherlands 999 17,7 Other Basal ganglia N.I. Y N Y T2DM N.I. Kammeyer, RM; 2020 M 61 USA 414 14 Hemichorea Basal ganglia + Other Ins + haldol + other P - Y T2DM >10 years Kandiah N 2009 M 75 Singapore 234 14,1 Hemichorea Basal ganglia N.I. N.I. N.I. Y N.S. N.I. Case 1 2009 M 80 Singapore 21 12,4 Hemichorea Basal ganglia N.I. N.I. N.I. N - - Case 2 2009 F 90 Singapore 378 13 Hemichorea Basal ganglia N.I. N.I. N.I. N - - Case 3 2009 F 78 Singapore 558 14,2 Hemichorea Basal ganglia N.I. N.I. N.I. Y N.S. N.I. Case 4 2009 M 81 Singapore 504 16,3 Hemichorea Basal ganglia N.I. N.I. N.I. N - - Case 5 2009 M 73 Singapore 234 10,9 Hemichorea Basal ganglia N.I. N.I. N.I. Y N.S. N.I. Kang, JH 2005 F 28 Korea 481 12,2 Hemichorea Basal ganglia insulin P - Y N.S. 5-10 years Karau, P 2020 F 52 Netherlands 594 11 Hemichorea Basal ganglia ins + hal Y N N - - Kashiura, M 2017 F 87 Australia 1125 8,5 Hemichorea Basal ganglia ins + hal Y N Y N.S. N.I. Kitagawa, M 2017 M 85 Japan 563 17 Other Basal ganglia Ins + other P - Y N.S. N.I. Koh, Yh 2007 M 76 Singapore 617,4 15 Hemichorea Basal ganglia Insulin Y N Y T1DM N.I. Kranick, SM 2008 F 52 USA 575 17,7 Hemichorea Basal ganglia Insulin Y N Y T1DM N.I. Kumar Vadi, S 2020 F 70 India 268 14,5 Hemichorea Basal ganglia N.I. P - Y T2DM >10 years Labbad, I 2020 F 53 Syria 441 12,9 Hemichorea Basal ganglia Insulin Y N N - - Lancellotti, G 2015 M 86 France 306 11,9 Hemichorea Basal ganglia + other Insulin Y Y Y N.S. N.I. Lee, BC Case 1 1999 F 78 Korea 216 11,3 Hemichorea Basal ganglia ins + hal Y N.I. Y N.S. <5 years Case 2 1999 F 77 Korea 232 11,2 Hemichorea Basal ganglia Ins + hal + bdz Y N.I. Y N.S. <5 years Case 3 1999 F 54 Korea 73 8,5 Hemichorea Basal ganglia Ins + hal Y N.I. Y N.S. 5-10 years Case 4 1999 F 77 Korea 387 15,3 Hemichorea Basal ganglia Ins + hal + bdz Y N.I. N - - Case 5 1999 F 80 Korea 500 10 Hemichorea Basal ganglia Insulin Y N.I. N - - Case 6 1999 F 70 Korea 359 15 Hemichorea Basal ganglia ins + hal Y N.I. Y N.S. >10 years Case 7 1999 F 56 Korea 488 19,2 Hemichorea Basal ganglia insulin Y N.I. Y N.S. >10 years Lee, D Case 1 2016 F 66 Korea 397 10 Hemichorea Basal ganglia Ins + hal + bdz N.I. N.I. N.I. N.I. N.I. Case 2 2016 F 67 Korea 587 15 Hemichorea Basal ganglia insulin Y N.I. N.I. N.I. N.I. Case 3 2016 F 69 Korea 167 5,9 Hemichorea Basal ganglia ins + bdz N.I. N.I. N.I. N.I. N.I. Case 4 2016 F 71 Korea 124 7 Hemichorea Basal ganglia ins + bdz Y N.I. N.I. N.I. N.I. Case 5 2016 F 74 Korea 532 14 Hemichorea Basal ganglia ins + hal N.I. N.I. N.I. N.I. N.I. Case 6 2016 F 75 Korea 152 7,4 Hemichorea Basal ganglia ins + bdz Y N.I. N.I. N.I. N.I. Case 7 2016 F 75 Korea 267 14,9 Hemichorea Basal ganglia Ins + hal + bdz N.I. N.I. N.I. N.I. N.I. Case 8 2016 F 80 Korea 371 11,3 Hemichorea Basal ganglia insulin Y N.I. N.I. N.I. N.I. Case 9 2016 M 80 Korea 239 14 Hemichorea Basal ganglia ins + bdz Y N.I. N.I. N.I. N.I. Case 10 2016 F 81 Korea 569 10 Hemichorea Basal ganglia ins + bdz Y N.I. N.I. N.I. N.I. Case 11 2016 F 81 Korea 205 13 Hemichorea Basal ganglia ins + bdz Y N.I. N.I. N.I. N.I. Lee, D (2) 2016 F 999 Korea 999 16,2 Hemichorea Basal ganglia insulin Y Y N.I. N.S. N.I. Lee, EJ Case 1 2002 F 74 USA 264 9,7 Hemichorea Basal ganglia Ins + hal + bdz Y N.I. Y N.S. N.I. Case 2 2002 F 47 USA 280 14,4 Hemichorea Basal ganglia Ins + hal + bdz Y N.I. Y N.S. N.I. Case 3 2002 F 43 USA 315 6,1 Hemichorea Basal ganglia N.I. Y N.I. Y N.S. N.I. Case 4 2002 F 81 USA 170 9,3 Hemichorea Basal ganglia ins + hal Y N.I. Y N.S. N.I. Case 5 2002 F 62 USA 283 13,2 Hemichorea Basal ganglia ins + hal Y N.I. Y N.S. N.I. Case 6 2002 F 57 USA 305 11,4 Hemichorea Basal ganglia Ins + hal + bdz Y N.I. Y N.S. N.I. Lee, P Case 1 2015 F 58 Singapore 1003 16,3 Hemichorea Other Insulin Y N Y T2DM >10 years Case 2 2015 F 76 Singapore 412 12,3 Hemichorea Basal ganglia Insulin N.I. N.I. Y T2DM N.I. Lee, SH N.I. Case 1 2011 F 60 Korea 738 13,5 Hemichorea Basal ganglia Insulin Y N.I. Y N.S. 5-10 years Case 2 2011 F 71 Korea 417 11,9 Hemichorea Basal ganglia Ins + hal + bdz Y N.I. Y N.S. >10 years Case 3 2011 M 90 Korea 325 16,6 Hemichorea Basal ganglia Ins + hal + bdz Y N.I. Y N.S. <5 years Case 4 2011 F 80 Korea 456 13,7 Hemichorea Other Ins + hal + bdz Y N.I. Y N.S. >10 years Case 5 2011 F 65 Korea 367 15,4 Hemichorea Basal ganglia insulin Y N.I. Y N.S. <5 years Case 6 2011 F 76 Korea 428 15,6 Hemichorea Basal ganglia Ins + hal + bdz Y N.I. Y N.S. >10 years Case 7 2011 F 62 Korea 269 14,5 Hemichorea Basal ganglia Ins + hal + bdz Y N.I. Y N.S. >10 years Case 8 2011 F 86 Korea 307 14,8 Hemichorea Basal ganglia ins + hal Y N.I. Y N.S. >10 years Case 9 2011 F 76 Korea 176 12,3 Hemichorea Other ins + hal Y N.I. Y N.S. <5 years Case 10 2011 F 56 Korea 402 12,2 Chorea Other Insulin Y N.I. Y N.S. <5 years Case 11 2011 F 82 Korea 208 12,4 Hemichorea Other ins + hal Y N.I. Y N.S. >10 years Case 12 2011 F 80 Korea 579 13,8 Hemichorea Basal ganglia ins + hal Y N.I. Y N.S. > 10 years Case 13 2011 M 73 Korea 249 11,2 Hemichorea Other ins + hal Y N.I. Y N.S. >10 years Case 14 2011 F 88 Korea 373 14,1 Hemichorea Other ins + bdz Y N.I. Y N.S. 5-10 years Case 15 2011 M 80 Korea 968 14 Hemichorea Basal ganglia Ins + Other N.I. N.I. Y N.S. 5-10 years Case 16 2011 M 78 Korea 640 14,8 Hemichorea Basal ganglia ins + bdz Y N.I. Y N.S. <5 years Case 17 2011 F 84 Korea 537 10,4 Hemichorea Other ins + bdz Y N.I. Y N.S. <5 years Case 18 2011 M 68 Korea 939 15,9 Hemichorea Other Insulin Y N.I. N - - Case 19 2011 M 74 Korea 214 14,5 Hemichorea Basal ganglia ins + hal Y N.I. Y N.S. >10 years Case 20 2011 M 57 Korea 790 15,1 Hemichorea Other Insulin Y N.I. N - - Lin, CJ 2017 M 73 Taiwan 200 17,3 Hemichorea Basal ganglia Ins + hal + bdz Y N.I. Y N.I. N.I. Lin, JB 2019 F 20 Singapore 999 14 Hemichorea Basal ganglia ins + bdz Y N Y T1DM >10 years Lucassen, EB 2017 F 57 USA 999 14 Hemichorea Basal ganglia Ins + Other P N Y T2DM N.I. Madu, E 2015 F 67 USA 392 7,5 Hemichorea Basal ganglia ins + bdz P N.I. Y T2DM N.I. Malzberg, GW 2020 M 79 USA 742 14,3 Chorea Basal ganglia Insulin Y N.I. Y T2DM N.I. Marmolejo, JPG Case 1 2020 M 64 Colombia 377 13,8 Hemichorea Basal ganglia ins + hal N N.I. Y T2DM <5 years Case 2 2020 F 66 Colombia 410 14 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM N.I. Massaro, F 2012 F 82 Italy 220 14,5 Chorea Basal ganglia Ins + other Y N N - - Matsuda, M 2001 F 76 Japan 264 8,2 Hemichorea Basal ganglia insulin Y Y Y N.S. >10 years Mihaela, B.V. 2011 M 62 France 432 12,6 Hemichorea Basal ganglia Ins + Other Y N N - - Modica, M.D 2015 F 71 USA 1013 16,3 Hemichorea Normal Insulin Y N.I. Y T2DM N.I. Mushtaq, U. 2016 F 71 USA 600 16 Chorea Normal Insulin Y N Y T2DM <5 years Nabatame, H 1994 F 78 Japan 401 15,1 Hemichorea Basal ganglia ins + hal Y N.I. Y N.S. N.I. Nakano, N 2005 M 65 Japan 96 10,9 Hemichorea Basal ganglia Ins + hal + bdz Y N.I. Y N.S. <5 years Nath, J 2006 F 50 USA 421 17,7 Hemichorea Basal ganglia Ins + hal + bdz Y N N - - Neupane, P. 2020 F 50 USA 1147 14 Hemichorea Normal Insulin Y N N - - Nishio, S 2015 M 68 Japan 596 14,4 Hemichorea Basal ganglia ins + hal Y N Y T2DM <5 years Ogawa, K 2008 F 73 Japan 611 11,7 Hemichorea Basal ganglia Ins + other Y N.I. Y N.S. 5-10 years Ohara, S 2001 M 92 Japan 320 17,4 Hemichorea Basal ganglia ins + hal N - Y N.S. N.I. Ohmori, H Case 1 2005 F 85 Japan 324 14,8 Hemichorea Basal ganglia Ins + other Y N.I. Y N.S. >10 years Case 2 2005 F 52 Japan 659 16,3 Hemichorea Basal ganglia ins + hal N - Y N.S. >10 years Özdilek, B 2012 F 58 Turkey 495 11 Chorea Basal ganglia ins + hal P - N - - Ozgür, A 2014 M 55 Turkey 246 15,4 Hemichorea Basal ganglia Insulin N.I. N.I. Y N.S. N.I. Padmanabhan, S 2013 F 76 Australia 439 17,3 Hemichorea Basal ganglia Insulin Y N N - - Panginikkod, S 2018 M 74 USA 450 13,6 Hemichorea Basal ganglia ins + bdz Y N Y T2DM >10 years Priola, AM 2014 F 87 Italy 410 18 Hemichorea Basal ganglia Insulin Y N Y T2DM N.I. Qiang, W 2020 M 71 China 756 14 Hemichorea Normal Insulin Y N N - - Quach, T. 2020 M 64 USA 254 14,6 Hemichorea Basal ganglia ins + bdz P - Y T2DM N.I. Raza, HK 2017 F 67 China 242 13,2 Chorea Basal ganglia Ins + other Y N.I. N - - Rodrigues, RK 2019 F 68 Brazil 330 9,9 Hemichorea Basal ganglia Ins + hal + bdz P - Y T2DM N.I. Roy, U 2016 M 52 India 354 16,2 Hemichorea Basal ganglia ins + hal N - N - - Sahu, D 2018 M 64 India 490 14,4 Hemichorea Basal ganglia ins + hal Y N.I. N - - Saleh, MM 2002 M 54 USA 256 10,5 Chorea Normal ins + hal P - N - - Satish, PV 2017 F 81 India 400 17,4 Hemichorea Basal ganglia ins + hal Y N Y T2DM N.I. Selçuk,F 2016 F 49 Turkey 400 12,1 Hemichorea Other ins + hal Y Y Y T2DM 5-10 years Shafran, I 2016 F 49 Israel 340 13,2 Hemichorea Basal ganglia N.I. Y N Y N.S. N.I. Shalini, B Case 1 2010 M 57 Malaysia 344 12,5 Hemichorea Basal ganglia ins + hal P - Y N.S. <5 years Case 2 2010 F 56 Malaysia 230 13,6 Hemichorea Basal ganglia ins + hal P - Y N.S. >10 years Case 3 2010 F 76 Malaysia 304 10,5 Hemichorea Basal ganglia ins + hal P - Y N.S. 5-10 years Shin, HW 2014 F 88 Korea 288 10,5 Hemichorea Basal ganglia ins + hal P - Y N.S. >10 years Slabu, H 2011 M 999 Canada 306 15,6 Hemichorea Basal ganglia Ins + outro P - Y T2DM <5 years Sohn, S.H 2011 F 67 Korea 398 10 Hemichorea Basal ganglia ins + hal Y N.I. Y N.S. >10 years Sperling, M 2018 M 63 USA 339 9,9 Hemichorea Basal ganglia Insulin Y N.I. Y N.S. >10 years Striano, P 2011 F 63 Italy 333 9 Hemichorea Basal ganglia ins + hal P - Y N.S. <5 years Su, CS Case 1 2012 M 63 Taiwan 360 19 Hemichorea Basal ganglia Insulin N - Y T2DM N.I. Case 2 2012 M 72 Taiwan 800 13,5 Hemichorea Basal ganglia Insulin N - Y T2DM N.I. Case 3 2012 M 70 Taiwan 999 14,5 Hemichorea Basal ganglia ins + hal N - Y T2DM N.I. Case 4 2012 M 72 Taiwan 999 7,3 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM N.I. Case 5 2012 F 72 Taiwan 426 12,9 Hemichorea Basal ganglia ins + hal N - Y T2DM N.I. Case 6 2012 F 66 Taiwan 400 8,3 Hemichorea Basal ganglia ins + hal N - Y T2DM N.I. Case 7 2012 F 73 Taiwan 800 14,3 Hemichorea Basal ganglia ins + hal N - Y T2DM N.I. Case 8 2012 F 83 Taiwan 200 8,6 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM N.I. Case 9 2012 F 64 Taiwan 700 15,4 Hemichorea Basal ganglia ins + hal Y Y Y T2DM N.I. Case 10 2012 F 83 Taiwan 255 13 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM N.I. Case 11 2012 F 82 Taiwan 316 10,3 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM N.I. Case 12 2012 F 80 Taiwan 450 10,2 Hemichorea Basal ganglia Insulin Y N.I. Y T2DM N.I. Case 13 2012 F 65 Taiwan 300 12,5 Hemichorea Basal ganglia Ins + other Y N.I. Y T2DM N.I. Case 14 2012 F 68 Taiwan 322 8,5 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM N.I. Case 15 2012 F 83 Taiwan 999 13,4 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM N.I. Case 16 2012 F 71 Taiwan 700 16,1 Hemichorea Basal ganglia Insulin Y N.I. Y T2DM N.I. Case 17 2012 F 18 Taiwan 367 12,9 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM N.I. Case 18 2012 M 80 Taiwan 451 13 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM N.I. Case 19 2012 F 67 Taiwan 396 16,3 Hemichorea Basal ganglia Insulin Y N.I. Y T2DM N.I. Case 20 2012 M 65 Taiwan 658 7,5 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM N.I. Case 21 2012 F 50 Taiwan 345 6,1 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM N.I. Suemaru, D 2015 F 83 Japan 950 15,1 Chorea Basal ganglia Insulin Y N.I. N LADA N.I. Suzuki 2013 F 66 Japan 600 13,3 Hemichorea Basal ganglia Ins + Other Y N Y N.S. >10 years Taguchi, Y 2010 M 76 Japan 348 15,1 Hemichorea Basal ganglia Insulin N.I. N.I. N - - Teodoro, T 2014 F 68 Portugal 500 15,8 Chorea Basal ganglia Ins + other P - Y N.S. N.I. Tidehag, L 2019 F 85 Sweden 1036 14,6 Hemichorea Basal ganglia ins + hal Y N.I. N - - Tsai, MC 2014 F 79 Taiwan 309 14,4 Hemichorea Basal ganglia Insulin Y N N - - Tung, CS 2010 M 56 Taiwan 400 13,8 Other Basal ganglia Ins + other P - Y N.S. 5-10 years Tyndall, EK 2020 N.I. 66 Italy 999 9,9 Hemichorea Basal ganglia Ins + hal + bdz P - Y N.S. N.I. Valenti, R 2012 F 75 Italy 270 13 Hemichorea Basal ganglia Ins + other P - Y T2DM 5-10 years Vasudevan, V 2018 M 64 India 409 14,1 Hemichorea Basal ganglia ins + hal P - N - - Wang, DM 2020 F 65 China 273 16,8 Hemichorea Basal ganglia ins + bdz Y Y Y T2DM >10 years Wang, W 2020 F 79 China 600 17,85 Hemichorea Basal ganglia ins + hal Y N.I. Y T2DM >10 years Wu, MN 2014 M 74 Taiwan 312 9 Hemichorea Basal ganglia Ins + hal + bdz N - Y N.S. N.I. Yahikozawa, H Case 1 1994 M 77 Japan 264 18,7 Hemichorea Basal ganglia ins + hal P - Y N.S. 5-10 years Case 2 1994 M 77 Japan 243 14,4 Hemichorea Basal ganglia Ins + other P - Y N.S. >10 years Case 3 1994 M 92 Japan 320 17,4 Hemichorea Basal ganglia ins + hal Y N Y N.S. <5 years Yokoi, K 2017 F 77 Japan 732 12,2 Hemichorea Basal ganglia ins + hal Y N Y N.S. N.I. Zétola, VF 2010 M 75 Brazil 600 14,4 Hemichorea Basal ganglia Insulin Y Y Y N.S. <5 years Zheng, W 2020 F 58 China 219 14,5 Hemichorea Basal ganglia ins + hal Y N Y T2DM >10 years Ziemann, U 2000 F 65 Germany 209 10,4 Hemichorea Basal ganglia ins + hal P - Y N.S. <5 years MRI: magnetic resonance imaging; T1DM: type 1 diabetes mellitus; T2DM: type 2 diabetes mellitus; LADA: latent autoimmune diabetes in adults; N. I.: not informed; N.A. not applicable; ins: insulin; hal: Haldol; bdz: benzodiazepine; Y: yes; N: no; P: partial; M: male; F: female; N. S.: not specified; UK: United Kingdom; USA: United States of America.

Publication Dates

  • Publication in this collection
    07 June 2024
  • Date of issue
    2024

History

  • Received
    11 May 2023
  • Accepted
    21 July 2023
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