Diabetic striatopathy: A case report of haemichorea in an older adult woman with poorly controlled diabetes.

Abstract

Uncontrolled type 2 diabetes (T2D) is associated with numerous microvascular and macrovascular complications. While clinical focus has often been on acute emergencies such as diabetic ketoacidosis and hyperosmolar hyperglycaemic state, rarer neurological complications also warrant attention. One such under-recognised complication is diabetic striatopathy (DS), also referred to as chorea-hyperglycaemia-basal ganglia syndrome or hyperglycaemia-induced chorea. We present the case of an older adult woman with poorly controlled T2D who developed progressive right-sided involuntary limb movements with twitching of the mouth. Clinical assessments and investigations confirmed DS, and her symptoms resolved completely with glycaemic optimisation and short-term risperidone for symptom relief. This case highlights the importance of recognising this uncommon presentation of uncontrolled T2D in the primary care setting, where timely diagnosis, as well as effective glycaemic optimisation, can lead to full recovery and a good prognosis.