A Case Report of a Reversible Movement Disorder in an Elderly Male with Late-onset Psychosis

Abstract

Abstract The approach to diagnosing and treating psychosis in the elderly is a complex challenge, especially in the setting of multiple comorbidities, and conflicting symptom domains. The patient described is an elderly male with diabetes, hypertension, and ischemic heart disease, with abnormal choreiform movements for 6 months, and psychotic symptoms for 2 months. Antipsychotics resulted in improvement of psychotic symptoms only. Neuroimaging revealed changes suggestive of nonketotic hyperglycemic hemichorea, which improved only with glycemic control. Balancing treatment with minimal impact on comorbidities is a delicate process to ensure correction of all possible reversible causes, as with this case.