{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T02:04:01Z","timestamp":1760061841927,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,23]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>We report the case of a 70-year-old diabetic woman who presented to the emergency department with multiple seizure episodes and coma, prompting the need for sedation and mechanical ventilation. She was transferred to our institution for neurosurgical evaluation as the initial CT scan identified hyperdense lesions in the left basal ganglia, interpreted as acute intracranial haemorrhage. On admission, laboratory tests were mostly normal except for blood glucose of 413 mg\/dL. Medical records revealed a history of poorly controlled diabetes mellitus and non-adherence to therapy. After seizure control and lifting sedation, right-sided ataxia\/involuntary movements were observed. Considering the patient\u2019s history and these findings, the CT scan was reviewed and the striatal region hyperdensities interpreted as lesions typical of non-ketotic hemichorea-hemiballismus. MRI was latter performed and confirmed the diagnosis, even though the unusual presentation. Levetiracetam initiation and glycaemic control optimisation led to great neurological improvement without seizure recurrence.<\/jats:p>","DOI":"10.1136\/bcr-2020-240083","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T00:51:34Z","timestamp":1612486294000},"page":"e240083","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Non-ketotic hemichorea-hemiballismus presenting as generalised tonic-clonic convulsive state in uncontrolled diabetes"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7253-8019","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Enes Silva","sequence":"first","affiliation":[{"name":"Internal Medicine, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4973-4473","authenticated-orcid":false,"given":"Joana Margarida Moreira","family":"Esteves","sequence":"additional","affiliation":[{"name":"Internal Medicine, Hospital Santa Maria Maior, Barcelos, Portugal"}]},{"given":"Ana Isabel","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Internal Medicine, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"given":"Celeste","family":"Dias","sequence":"additional","affiliation":[{"name":"Neurocritical Care Unit, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"},{"name":"Invited Professor, Faculty of Medicine, University of Porto, Porto, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"2025082702135946000_14.2.e240083.1","unstructured":"Diabetes - Key facts . WHO fact sheets, 2020. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/diabetes [Accessed 9 Oct 2020]."},{"key":"2025082702135946000_14.2.e240083.2","first-page":"e165","article-title":"Hyperglycemia-Induced involuntary movements: 2 case reports and a review of the literature","volume":"1","author":"Borensztein","year":"2015","journal-title":"AACE Clin Case Rep"},{"key":"2025082702135946000_14.2.e240083.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(02)00133-8"},{"key":"2025082702135946000_14.2.e240083.4","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-59121-0"},{"key":"2025082702135946000_14.2.e240083.5","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-7-1"},{"key":"2025082702135946000_14.2.e240083.6","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.28126"},{"key":"2025082702135946000_14.2.e240083.7","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1968.00480050095009"},{"key":"2025082702135946000_14.2.e240083.8","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410080205"},{"key":"2025082702135946000_14.2.e240083.9","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-009-0127-6"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240083","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:14:07Z","timestamp":1756286047000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,4]]},"published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1136\/bcr-2020-240083"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240083","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,2]]}}}