Mixed movement disorder as the presenting manifestation of non-ketotic hyperglycemia.

Focal neurological symptoms may provide the first clue to the presence of nonketotic hyperglycemia (NKH). We report a patient with hemichorea-hemiballism (HC-HB) as the first manifestation of NKH. CT Brain revealed hyperdensity in bilateral globus pallidus (GP) and putamen predominantly on right side. Blood sugar was 580 mg/dl and s. osmolality was 316 mosm/l. This condition resolved after correction of hyperglycemia. The possible mechanism by which NKH causes this condition is discussed.