Easily missed or misinterpreted: diabetic striatopathy in the course of ketotic hyperglycaemia.

A 61-year-old man suffering from diabetes mellitus type 2 (DM2) for 10 years and a 67-year-old woman with no medical history developed subacutely unilateral involuntary movements. The former patient demonstrated moderate hemichorea-hemiballism (HC-HB) in the left limbs for 3 weeks, while the latter patient presented mild hemichorea in the right upper limb for 1 week (online supplemental video showing symptoms of the second patient). Laboratory tests revealed hyperglycaemia (random blood glucose levels: 470 mg/dL and 560 mg/dL, respectively) and elevated glycosylated haemoglobin A1c levels (15.4% and 13.1%, respectively) with positive urine ketones and normal blood gas analysis. Both brain CT and MRI showed lesions in the striatum contralateral to …