Case Report

Dancing Movements Due to Endocrine Deficiencies: A Case Report

DOI https://doi.org/10.70302/jpsim.v3i3.2250
Received: 25 Mar 2022 Accepted: 23 Jul 2022 Published Online: 12 Sep 2022

Abstract

Choreiform-ballistic movements have often been associated with lesions in basal ganglia and sub-thalamic nucleus. For a patient with dancing movements, hyperglycemia might be an initial presentation. We report a rare case of 19 years old Asian girl who had type I diabetes mellitus and Developed choreiform-ballistic type movements. She had ketoacidosis secondary to uncontrolled hyperglycemia along with hypocalcaemia secondary to either pseudo hypoparathyroidism??? On CT brain plain basal ganglia were heavily calcified. We optimized her diabetes management along with calcium and vitamin D analogues (calcitriol or alfacalcidol) and her symptoms got improved dramatically without using any specific antidopaminergic therapy or nerve stabilisers. Adults with mixed endocrine deficiencies can present with unique symptoms like choreiform-ballistic type movements that can be improved with exogenous administration/replacement of deficient harmones' analogues like in above mentioned case with insulin as well as calcium and vitamin D analogues supplementation.

Keywords
Choreiform movements intact parathormone level (iPTH) ballistic movements pseudo hypopara-thyroidism type I diabetes mellitus basal ganglia sub-thalamus nuclei caudate and lenticular exogenous.

How to Cite This Article

Haroon M. Dancing Movements Due to Endocrine Deficiencies: A Case Report. J Pak Soc Intern Med. 2022;3(3):250–252. doi:10.70302/jpsim.v3i3.2250

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

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References

  1. Hashimoto KI, Ito Y, Tanahashi H, Hayashi M, Yamakita N, Yasuda K. Hyperglycemic chorea-ballism or acute exacerbation of Huntington's chorea? Huntington's disease unmasked by diabetic ketoacidosis in type 1 diabetes mellitus. J Clin Endocrinol Metabol. 2012;97(9):3016-20.
  2. Cleveland Clinic. Chorea. [updated 2020, cited July 2022] Available from: [https://my.clevelandclinic.org/health/diseases/21192-chorea]
  3. Insogna KL. Primary hyperparathyroidism. New Eng J Med. 2018;379(11):1050-9.
  4. Coppen EM, Roos RA. Current pharmacological approaches to reduce chorea in Huntington’s disease. Drugs. 2017;77(1):29-46.
  5. Piret SE, Thakker RV. Mouse models for inherited endocrine and metabolic disorders. J Endocrinol. 2011 ;211(3):211-30.
  6. Maiti A, Chatterjee S. Neuropsychiatric manifestations and their outcomes in chronic hypocalcaemia. J Indian Med Assoc. 2013;111(3):174-7.
  7. Ferri FF, editor. Ferri's Clinical Advisor 2022, E-Book. Elsevier Health Sciences; 2021 Jun 9.
  8. Patki R, Douglas R, Rimareva N, Kondamudi N. Uncontrollable movements of right upper and lower extremities in a child: A diagnostic puzzle. J Am Col Emerg Physic Open. 2021;2(4):e12497.

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