Case report reveals that hyperglycemia can cause oromandibular dystonia and dysphagia, indicating the need for early detection through FEES.
Background: Hyperglycemia-induced movement disorders usually present as hemichorea or hemiballismus. Non-choreiform presentations are rare and often overlooked. Case Report: We present the case of a 36-year-old man with uncontrolled type 2 diabetes who developed painful oromandibular dystonia, dysarthria and dysphagia. These symptoms were investigated using flexible endoscopic evaluation of swallowing (FEES). An MRI revealed reversible T2 hyperintensities in the pons without striatal involvement. The symptoms resolved with insulin normalization and tetrabenazine treatment. Discussion: Transient brainstem dysfunction due to hyperglycemia may present with oromandibular dystonia and dysphagia. FEES facilitates early detection of subtle yet clinically relevant complications.
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Lueg et al. (2025) studied this question.
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