Case Presentation A 63-year-old woman with a history of type 2 diabetes mellitus and morbid obesity presented with a one-day history of sudden involuntary movements affecting her left upper and lower limbs. She described the movements as irregular, low-frequency, and large-amplitude, which prevented her from holding objects.
She denied aura, loss of consciousness, or post-ictal confusion. Medical History Type 2 diabetes mellitus since 2008 (on metformin, empagliflozin, and gliclazide) Prior hyperosmolar hyperglycaemic state requiring admission Temporal lobe epilepsy diagnosed 18 years ago, seizure-free for 12 years on carbamazepine No neurology follow-up in the last decade BMI: 44.9 kg/m² Recent history of sore throat, dry cough, fatigue, and increased frequency of micturition prior to presentation Physical Examination Alert, oriented, Glasgow Coma Score (GCS) 15/15 Irregular,…
