Clinical Neuroscience

A case study of acute oropharyngeal palsy concomitant with diabetic ketoacidosis

LANTOS Judit 1, BARTA Zsanett 2, NAGY Albert , VINCZE Rita 1, FÜLE Kálmán 1, BIHARI Katalin 1

JULY 30, 2022

Clinical Neuroscience - 2022;75(07-08)

DOI: https://doi.org/10.18071/isz.75.0275

Case Reports

Acute oropharyngeal palsy is a rare variant of Guillain-Barré syndrome. In our study we present the case of a 63-year-old man with general symptoms who was diagnosed with diabetic ketoacidosis and prescribed insulin therapy. Two weeks later, the patient complained of paraesthesia of the perioral region and the tip of the tongue, dysphagia, and dysarthria. These symptoms were initially thought to be complications of the patient’s type-1 diabetes. Due to rapidly developing paraparesis, the patient became bedridden. Clinical symptoms, cerebrospinal fluid analysis and a nerve conduction study resulted in a diagnosis of acute oropharyngeal palsy, a variant of Guillain-Barré syndrome. After five consecutive days of intravenous immunoglobulin treatment, neurological symptoms improved and the need for insulin ceased. One year later, the patient’s only remaining neurological symptom was loss of tendon reflexes in the lower extremities. Furthermore, the patient’s blood glucose level was normal without the use of medications or a special diet. Here, we report that oropharyngeal palsy can co-occur with diabetic ketoacidosis, and that immuntherapy is effective in treating both oropharyngeal palsy and type-1 diabetes. To our knowledge, this is the first description of a patient presenting with acut oropharyngeal palsy concomitant with diabetic ketoacidosis.

AFFILIATIONS

  1. Bács-Kiskun County Hospital, Neurology and Stroke Department, Kecskemét
  2. University of Szeged, Department of Surgery, Szeged

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