Acute oropharyngeal palsy is a rare subtype of Guillain-Barré syndrome. It is characterized by dysphagia and diminished deep tendon reflexes, while notably sparing limb muscle weakness and orbicularis oculi paralysis. Due to its rarity, dysphagia caused by acute oropharyngeal palsy may remain undiagnosed. We report a case of dysphagia that developed following diabetic ketoacidosis. The patient was a man in his 70s who was transported to our hospital by emergency services due to diabetic ketoacidosis. Severe dysphagia persisted despite the successful management of his diabetic ketoacidosis. Although the diagnosis was challenging, we established a diagnosis of acute oropharyngeal palsy based on physical examination findings and cerebrospinal fluid analysis results. We observed improvement in dysphagia caused by acute oropharyngeal palsy following balloon dilation therapy. We present this case to emphasize the importance of including acute oropharyngeal palsy in the differential diagnosis when evaluating patients with bulbar palsy.

Acute oropharyngeal palsy is a rare subtype of Guillain-Barré syndrome. It is characterized by dysphagia and diminished deep tendon reflexes, while notably sparing limb muscle weakness and orbicularis oculi paralysis. Due to its rarity, dysphagia caused by acute oropharyngeal palsy may remain undiagnosed. We report a case of dysphagia that developed following diabetic ketoacidosis. The patient was a man in his 70s who was transported to our hospital by emergency services due to diabetic ketoacidosis. Severe dysphagia persisted despite the successful management of his diabetic ketoacidosis. Although the diagnosis was challenging, we established a diagnosis of acute oropharyngeal palsy based on physical examination findings and cerebrospinal fluid analysis results. We observed improvement in dysphagia caused by acute oropharyngeal palsy following balloon dilation therapy. We present this case to emphasize the importance of including acute oropharyngeal palsy in the differential diagnosis when evaluating patients with bulbar palsy.

In the Great East Japan Earthquake and disaster, much of the Pacific coastline of Miyagi Prefecture was devastated by a tsunami. Though physical damage to our hospital was minimal, both the flow of information and the hospital's lifeline were interrupted. During this time supplies to our hospital were insufficient, yet we still gave medical assistance to the disaster victims. Physically handicapped people faced extreme difficulty in all aspects of everyday life such as moving to a refuge center, eating, going to the toilet and securing a place to lie down at the refuge center. Physically handicapped people left in homes cut off from the outside also faced many difficulties. We commenced medical assistance at the refuge center 3 days after the tsunami hit. Many assistants came from other hospitals affiliated with MIN-IREN (Japan Federation of Democratic Medical Institutions) throughout the country. We commenced rehabilitation support at the refuge center from April. While at the refuge center, handicapped people had to deal with many obstacles such as the distance to the toilets, toilet structure, stairs and steps etc. From June, we began assistance at the temporary housing sites. Going forward, our future problem is providing disaster victim health management support at the temporary housing sites, and also providing assistance in setting up a network of sympathetic residents to prevent isolation. In light of our experience, from the perspective of a disaster management strategy, there is a definite need to perfect a government-centered support system that focuses on physically handicapped people immediately after a disaster. This is particularly important from the perspective of rehabilitation, as the challenge is to create post-disaster rehabilitation support teams.