Progressive structural changes in the putamen in a case of recurrent diabetic chorea with late-onset reduced arm swing

The detailed mechanism underlying diabetic chorea remains uncertain. We present a male patient with recurrent diabetic hemichorea with late-onset reduced arm swing. We explored the association between hyperglycemia, changes in neurological manifestations, and brain magnetic resonance imaging findings. Hyperglycemic control did not prevent the following progressive structural changes in the putamen. Slow progressive structural changes in the putamen may lead to the recurrence of chorea and the appearance of late-onset reduced arm swing. We speculated that hyperglycemia-related vasculopathy and subsequent structural changes in the putamen may play a crucial role in diabetic chorea.