Acute movement disorders might be a complication of diabetes: Clinical series of 59 patients
West Bengal: A clinical series of 59 patients have depicted the clinical-radiological spectrum of acute onset movement disorders in diabetes mellitus (DM). Almost one third of patients had nonchoreic and nonballistic movements, the researchers noted.The findings of the study, published in the European Journal of Neurology, underscore the importance of a capillary blood glucose measurement...
West Bengal: A clinical series of 59 patients have depicted the clinical-radiological spectrum of acute onset movement disorders in diabetes mellitus (DM). Almost one third of patients had nonchoreic and nonballistic movements, the researchers noted.
The findings of the study, published in the European Journal of Neurology, underscore the importance of a capillary blood glucose measurement in acute or subacute onset movement disorders patients regardless of their past glycemic status.
No previous study has assessed the clinical–radiological characteristics and frequency of patients with diabetes and acute onset nonchoreic and nonballistic movements. Julián Benito-León, Network Biomedical Research Center on Neurodegenerative Diseases, Madrid, Spain, and colleagues conducted a prospective study to investigate the spectrum of acute onset movement disorders in DM.
For this purpose, the researchers recruited all patients with acute onset movement disorders and hyperglycemia who attended the wards of three hospitals in West Bengal, India from August 2014 to July 2021.
Based on the study, the researchers reported the following:
- Among the 59 patients (mean age = 55.4 ± 14.3 years, 52.5% men) who were included, 69.5% had choreic or ballistic movements, and 30.5% had nonchoreic and nonballistic movements.
- Ballism was the most common movement disorder (30.5%), followed by pure chorea (25.4%), choreoathetosis (13.6%), tremor (8.5%), hemifacial spasm (5.1%), parkinsonism (5.1%), myoclonus (5.1%), dystonia (3.4%), and restless leg syndrome (3.4%).
- The mean duration of DM was 9.8 ± 11.4 years (89.8% of the patients had type 2 DM).
- Nonketotic hyperglycemia was frequently (76.3%) detected. The majority (55.9%) had no magnetic resonance imaging (MRI) changes; the remaining showed striatal hyperintensity.
- Eight patients with MRI changes exhibited discordance with sidedness of movements. Most of the patients (76.3%) recovered completely.
To conclude, acute movement disorders might be a complication of diabetes mellitus.
"The findings highlight the importance of the measurement of capillary blood glucose in patients with acute or subacute onset movement disorders regardless of their past glycemic status," wrote the authors. "The commonest movement disorders identified were ballism followed by pure chorea, although other simple and complex movement disorders may stem from poor glycemic control overall or acute disturbance of blood glucose level."
"Clinical–radiological discordance is not rare. Treatment with insulin alone helps reduce abnormal movements, although the role of adding on other medications cannot be ignored."
Reference:
Dubey S, Chatterjee S, Ghosh R, Louis ED, Hazra A, Sengupta S, Das S, Banerjee A, Pandit A, Ray BK, Benito-León J. Acute onset movement disorders in diabetes mellitus: A clinical series of 59 patients. Eur J Neurol. 2022 Apr 11. doi: 10.1111/ene.15353. Epub ahead of print. PMID: 35403331.
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