{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:21:52Z","timestamp":1755217312980,"version":"3.43.0"},"reference-count":14,"publisher":"Ubiquity Press, Ltd.","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TOHM"],"abstract":"<jats:p>Background: Hyperglycemia-induced movement disorders usually present as hemichorea or hemiballismus. Non-choreiform presentations are rare and often overlooked.\nCase 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.\nDiscussion: Transient brainstem dysfunction due to hyperglycemia may present with oromandibular dystonia and dysphagia. FEES facilitates early detection of subtle yet clinically relevant complications.<\/jats:p>","DOI":"10.5334\/tohm.1062","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T11:40:00Z","timestamp":1754394000000},"page":"35","source":"Crossref","is-referenced-by-count":0,"title":["Oromandibular Dystonia and Dysphagia in Hyperglycemic Brainstem Dysfunction"],"prefix":"10.5334","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0143-2556","authenticated-orcid":false,"given":"Gero","family":"Lueg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5797-834X","authenticated-orcid":false,"given":"Timm","family":"Westhoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Fruth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regina","family":"Kerkmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2219-5593","authenticated-orcid":false,"given":"Julia","family":"Kr\u00e4mer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3285","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"issue":"8","key":"key20250805113955_B1","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1111\/ene.15353","article-title":"Acute onset movement disorders in diabetes mellitus: A clinical series of 59 patients","volume":"29","year":"2022","journal-title":"European Journal of Neurology"},{"issue":"6","key":"key20250805113955_B2","first-page":"10.1212\/CPJ.000","article-title":"Hyperglycemic Hyperosmolar Syndrome Presenting With Unique Craniofacial Involuntary Movements","volume":"11","year":"2021","journal-title":"Neurology Clinical Practice"},{"issue":"1","key":"key20250805113955_B3","article-title":"\u201cDiabetic striatopathy\u201d: clinical presentations, controversy, pathogenesis, treatments, and outcomes","volume":"10","year":"2020","journal-title":"Scientific Reports"},{"issue":"1","key":"key20250805113955_B4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40618-023-02166-5","article-title":"Diabetic striatopathy: an updated overview of current knowledge and future perspectives","volume":"47","year":"2023","journal-title":"Journal of Endocrinological Investigation"},{"issue":"5","key":"key20250805113955_B5","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1159\/000524936","article-title":"Neuroimaging of Diabetic Striatopathy: More Questions than Answers","volume":"85","year":"2022","journal-title":"European Neurology"},{"issue":"3","key":"key20250805113955_B6","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1179\/1743132812Y.0000000009","article-title":"More often striatal myelinolysis than pontine? A consecutive series of patients with osmotic demyelination syndrome","volume":"34","year":"2012","journal-title":"Neurological Research"},{"issue":"04","key":"key20250805113955_B7","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.11622\/smedj.2015065","article-title":"Central pontine myelinolysis: a rare presentation secondary to hyperglycaemia","volume":"56","year":"2015","journal-title":"Singapore Medical Journal"},{"key":"key20250805113955_B8","first-page":"14","article-title":"Central pontine myelinolysis: a rare finding in hyperosmolar hyperglycemia","year":"2023","journal-title":"Frontiers in Neurology"},{"issue":"3","key":"key20250805113955_B9","doi-asserted-by":"crossref","first-page":"102997","DOI":"10.1016\/j.dsx.2024.102997","article-title":"Diabetic striatopathy and other acute onset de novo movement disorders in hyperglycemia","volume":"18","year":"2024","journal-title":"Diabetes & Metabolic Syndrome: Clinical Research & Reviews"},{"key":"key20250805113955_B10","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.jns.2017.01.024","article-title":"Temporal evolution of the trident and piglet signs of osmotic demyelination syndrome","volume":"373","year":"2017","journal-title":"Journal of the Neurological Sciences"},{"issue":"2","key":"key20250805113955_B11","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s12028-009-9241-9","article-title":"Central Pontine Myelinolysis in a Patient with Hyperosmolar Hyperglycemia and Consistently Normal Serum Sodium","volume":"11","year":"2009","journal-title":"Neurocritical Care"},{"issue":"11","key":"key20250805113955_B12","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.2169\/internalmedicine.2451-23","article-title":"Osmotic Demyelination Syndrome in a Patient with Diabetic Ketoacidosis despite No Rapid Sodium Correction","volume":"63","year":"2024","journal-title":"Internal Medicine"},{"issue":"7","key":"key20250805113955_B13","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1111\/imj.15855","article-title":"Osmotic demyelination syndrome: novel risk factors and proposed pathophysiology","volume":"53","year":"2023","journal-title":"Internal Medicine Journal"},{"key":"key20250805113955_B14","first-page":"1","article-title":"Osmotic Demyelination Syndrome as the Initial Manifestation of a Hyperosmolar Hyperglycemic State","volume":"2014","year":"2014","journal-title":"Case Reports in Neurological Medicine"}],"container-title":["Tremor and Other Hyperkinetic Movements"],"original-title":[],"link":[{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/download\/1062\/2044","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/download\/1062\/2045","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/download\/1062\/2046","content-type":"video\/mp4","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/download\/1062\/2044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T11:43:38Z","timestamp":1754394218000},"score":1,"resource":{"primary":{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/view\/1062"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,5]]},"references-count":14,"URL":"https:\/\/doi.org\/10.5334\/tohm.1062","relation":{},"ISSN":["2160-8288"],"issn-type":[{"type":"electronic","value":"2160-8288"}],"subject":[],"published":{"date-parts":[[2025,8,5]]}}}