Generalized choreoathetosis secondary to non-ketotic hyperglycemic disorder

Introduction: Type 2 diabetes mellitus is one of the diseases that is most associated with chorea, and although it is a rare complication, it is necessary tobe aware of it so that the correct diagnosis and early treatment can be made. Case report: Male patient, 78 years old, diabetic and uncontrolled hypertension. Began uncontrolled glycemic 7 days before admission. Evolves with imbalance when walking and with involuntary movements in the left upper limb. At admission, dextro 682 mg/dl and at neurological exam the presence of asymmetric choreoathetotic movements, more evident in the left dimidium. Investigation with neuroimaging, brain tomography showed the presence of hyperdensity in bilateral basal nuclei, confirmed by brain MRI. Other differential diagnoses were ruled out, such as hyperthyroidism, liver failure and rheumatic fever. The most likely diagnosis was generalized choreoathetosis secondary to a non-ketotic hyperglycemic disorder. During hospitalization, adequate glycemic control was performed and clonazepam was introduced as an aid, with significant improvement of movements and absence of the same at discharge. Conclusions: Cases of non-ketotic hyperglycemia are associated with the onset of chorea, and although it is a rare complication, it is not uncommon given the high incidence of diabetes mellitus in the Brazilian population, and clinical improvement may take weeks to months, even after adequate glycemic control.