The case of an 85‐year‐old woman with subacute onset of bilateral chorea

An elderly woman presented with subacute onset of chorea following a hospitalization for severe, uncontrolled diabetes, a urinary tract infection, and 6 months of depression. Her neurological examination demonstrated bilateral chorea involving the arms, legs, and jaw. MRI of the brain demonstrated bilateral T1 hyperintensity. She was diagnosed with diabetic striatopathy, also known as nonketotic hyperglycemic chorea, a rare complication of diabetes mellitus that classically causes hemichorea in the setting of very high blood glucose without ketosis. This case demonstrates typical imaging findings of diabetic striatopathy despite several atypical clinical features, including bilateral chorea, development of symptoms weeks after improvement in blood glucose, and demographics of the patient. Diabetic striatopathy.1, 2