Non-ketotic hyperglycaemic hemichorea is a rare metabolic disorder seen primarily in elderly patients with poorly controlled type 2 diabetes mellitus. It is characterised by unilateral choreiform movements, typically affecting one side of the body, and is often misdiagnosed due to its unusual presentation. We report the case of a 90-year-old female with a known history of uncontrolled type 2 diabetes mellitus with serum glucose level of ~ 400 mg/dl, if who presented with continuous involuntary movements of her left upper and lower limbs. Brain imaging showedhyperdensityon CT and hyperintensity changes on MRI in the right basal ganglia, particularly the caudate and lentiform nuclei. These results were reliable with NKHH. Early diagnosis is important in preventing long-term neurological complications and initiating appropriate glycaemic control and radiological diagnosis. This supports its differentiation from other neurodegenerative and metabolic disorders; the report emphasises the imaging findings of NKHH.

Non-ketotic hyperglycaemia, Hemichorea, Chorea-hyperglycaemia-basal ganglia syndrome