[Stiff-person syndrome mistaken for conversive disorder: a common error].

Rev Med Chil

Departamento de Ciencias Neurológicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

Published: June 2019

AI Article Synopsis

  • Stiff-person syndrome causes persistent muscle spasms, primarily in the lower limbs and trunk, triggered by minor sensory stimuli and becoming continuous and painful over time.
  • The syndrome often gets misdiagnosed as a conversion disorder, as illustrated in a case where a patient was misdiagnosed for two years before the correct diagnosis was made, coinciding with her autoimmune condition.
  • Treatment showed positive results with intravenous immunoglobulin, mycophenolate mofetil, and muscle relaxant tranquilizers.

Article Abstract

Stiff-person syndrome is characterized by persistent muscle spasms, involving agonist and antagonist muscles simultaneously, starting in the lower limbs and trunk. It tends to occur in the fourth to sixth decade of life, presenting with intermittent spasms that later become continuous and usually painful. Minor sensory stimuli, such as noise or light touch, precipitate severe spasms. Spasms do not occur during sleep and only rarely involve cranial muscles. We present a case that for two years was diagnosed and treated as a conversion disorder associated with depression. After two years she was admitted to another hospital with an unmistakable picture of stiff-person syndrome with hypertrophy and rigidity of lower limb muscles, compatible electrophysiology and positive anti-GAD antibodies. She had autoimmune hypothyroidism, that should have raised the suspicion of stiff-person syndrome earlier. She responded to intravenous immunoglobulin and mycophenolate mofetil and and to tranquilizers that have muscle relaxant properties.

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Source
http://dx.doi.org/10.4067/S0034-98872019000600799DOI Listing

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