This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Hemichorea hemiballismus syndrome (HCHB) is commonly seen in an acute setting of non ketotic hyperglycaemia. Hemichorea hemiballismus has been rarely reported in the setting of normal blood sugars in a diabetic patient. We report an 84-year-old lady who initially presented with uncontrolled diabetes and acute left hemiparesis. Imaging did not reveal any evidence of recent infarction. After sugars were normalised, five weeks later she presented with involuntary movements of left upper and lower limb. On examination, patient had left hemichorea hemiballismus. Repeat MRI brain showed right putamen hyperintensity in T1 weighted images. Venous blood glucose was 123 mg/dl (6.8 mmol/L). Patient improved significantly with haloperidol and clonazepam. In conclusion, hemichorea hemiballismus can be observed in a patient with previously uncontrolled diabetes mellitus after normalization of blood sugars akin to that seen in patients with HCHB associated with hyperglycaemia.