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Dewa Putu Gede Purwa Samatra
Bagian Neurologi Fakultas Kedokteran Universitas Udayana/ Rumah Sakit Umum Pusat Sanglah Denpasar Bali
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Journal : Neurona

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PENDEKATAN DIAGNOSIS DAN MANAJEMEN CHOREA PADA KONDISI HIPERGLIKEMIA HIPEROSMOLAR NON KETOTIK: LAPORAN KASUS Valentina Tjandra Dewi; Sri Yenni Trisnawati; Dewa Putu Gde Purwa Samatra
NEURONA Vol 39 No 1 (2021)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i1.333

Abstract

Abstract Introduction: Chorea can be classified based on its etiology as primary and secondary chorea. Primary chorea is idiopathic/genetic, while secondary chorea is associated with infections, metabolic, endocrine, and immune disorders, or drug-induced. One of the metabolic disorders that can manifest as chorea is hyperglycemic state, which is commonly found in people with uncontrolled diabetes mellitus. Case Report: A 70-year-old man came to the emergency room with involuntary and irregular movements which appeared like dancing movements along his left upper limb. The patient had a history of uncontrolled type-2 diabetes mellitus (DM) and it was known that the blood glucose result on admission was 926 mg / dL and HbA1C 15.4%. Blood glucose regulation was carried out by the endocrinology department with rehydration and administering intravenous rapid acting insulin infusion, later on, the chorea symptoms disappeared within 24 hours after glycemic control and adding of dopamine antagonist drug. Discussion: Hyperglycemia can impair perfusion of the contralateral striatum and disrupt Gamma Amino Butyric Acid (GABA) resulting in excessive inhibition of the subthalamic nucleus and hyperexcitation of the thalamocortical system. When diagnosing chorea, a comprehensive evaluation of patient history, neurological examination, laboratory tests, and imaging are essential. Management of chorea relies on the identification of underlying etiology. Conclusion: Most cases of chorea or hemichorea induced by non-ketotic hyperglycemia have a good prognosis. Blood glucose regulation is the mainstay of therapy, while dopamine receptor antagonist drugs are sometimes required in cases where symptoms are not fully improved. Keywords: chorea, non ketotic hyperglycemia, involuntary movements
Co-Authors Agus Antara, Agus Anak Agung Ayu Meidiary Anak Agung Ayu Putri Laksmidewi Anak Agung Ayu Suryapraba Anak Agung Bagus Ngurah Nuartha Anak Agung Gede Sudewa Djelantik Asrul Sani Astari Arum Cendani Goller Bagus Komang Satriyasa Bagus Ngurah Mahasena Putra Awatara Bhaskoro Adi Widie Nugroho, Bhaskoro Adi Widie Candida Isabel Lopes Sam Devi, Gusti Ayu Putu Giti Livia Dewa Putu Wisnu Wardhana Dyah Esti Pranwengrum Fitratun Najizah Haditya, Yogi I Dewa Ayu Inten Dwi Primayanti I Dewa Putu Sutjana I Gusti Ayu Widianti I Gusti Ngurah Ketut Budiarsa I Ketut Suastika I Ketut Sumada I M. P. Kesanda, I M. P. I Made Krisna Dinata I Made Oka Adnyana I Nyoman Adi Putra I Nyoman Mangku Karmaya I Putu Eka Widyadharma I Putu Gede Adiatmika I Putu Gede Wikandikta I. A. A. Indrayani, I. A. A. Ida Ayu Sri Indrayani Ida Ayu Sri Wijayanti Indra Lesmana Ketut Widyastuti Kumara Tini Lely Setyawati Kurniawan Lim, Demetria Jesica Luh Ita Mahendrayani Luh Made Indah Sri Handari Adiputra Luh Putu Ratna Sundari M. Irfan Muhammad Irfan Muhammad Ruslan Nuryanto Mutiah Munawarah Nadya Bianca Ni Ketut Candra Wiratmi Ni Made Linawati Ni Nyoman Ayu Dewi Ni Nyoman Ayu Dewi Ni Putu Winda Apriyanti Ni Wayan Tianing Nitaya Putri Nur Hidayat Nuri Putri Ayu P, Sukarini Pristanova Larasanti Purna Putra IGN Putra IGN, Purna Putri Eka Pradnyaning Putu Agus Grantika, Putu Agus Putu Gede Sudira Putu Lohita Rahmawati Rizki Novrianti S. Indra Lesmana Sawitri, Anak Agung Sagung Sri Yenni Trisnawati Sugijanto - Sugijanto - Sugijanto Sugijanto Sukarini P Suryamulyawan, Kadek Adi Susy Purnawati Syahmirza Indra Lesmana TATI NURHAYATI Thomas Eko Purwata Tjokorda Gde Bagus Mahadewa Tri Wahyu Wulandari Trisa Permata Suhadi Trisha Anindya Trisha Indah Paramita Trisnawati, Sri Yenni Valentina Tjandra Dewi Valentina Tjandra Dewi Virny Dwiya Lestari Wahyuddin, Wahyuddin Wayan Westa Winda Haeriyoko Yusuf Nasirudin