Stiff Person Syndrome: A Case Report and Review

The case revolves around a 26-year-old male patient who was brought to the General Medicine ward for his otherwise non-serious condition. This patient had developed painful spasms and stiffness in both his legs in the last three days. Due to this complaint, the patient was unable to stand up without difficulty and, as a result, was unable to walk properly. There was no history of animal or insect bites, or wounds, and there were no infected wounds or abscesses present on his legs. Upon request, the patient said that his job requires him to stand for prolonged hours in the hot weather. However, over time, his symptoms appeared to worsen and generalize. Therefore, he was admitted to the General Medicine ward for suspected heatstroke along with rhabdomyolysis. His renal function tests were normal, and his CK levels were > 2000 IU/l.

Overall, the patient appeared stable and fully conscious, well-oriented to time and place, and afebrile. However, he seemed to resist movement and therefore looked rigid in his overall appearance. However, (to avoid using ‘however’ again, you could start with: ‘Despite this, his…’) his symptoms greatly improved to the point of nearly disappearing when he was resting or asleep. The patient also had to be shifted to the ICU to stabilize his muscle stiffness, where he developed a few complications such as acute kidney injury, severe lactic acidosis, desaturation, tachycardia, and reduced urine output. In the middle of all this, (Or: ‘During all this,’) there was no abnormality seen in neuroimaging or from electrophysiological studies. However, the raised level of anti-GAD antibodies combined with the patient's history and examination findings all pointed towards the patient suffering from Stiff Person Syndrome (SPS). However, since this case was already proving to be both complicated and difficult to diagnose, there must be (or ‘needs to be’) a systematic way of ruling out the other possible causes of the symptoms and the complications that arise in a given patient to make sure that there are no errors in diagnosing the case or intervening accordingly. Failure to do so can complicate the condition and deteriorate the patient’s condition further. Therefore, this case study aims to target those areas that point towards diagnosing this condition early and in a better way. This study also focuses on the possible treatment and management plans that should be systematically carried out on suspected patients of Stiff Person Syndrome to ensure their timely survival and to prevent complications.