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Sudden spasms following gradual lordosis--the stiff-person syndrome
Robin K Wilson1, Beth B Murinson
1Johns Hopkins Adult Hydrocephalus Program, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Background:
A 28-year-old woman presented to hospital after an episode of severe lower back spasms that occurred during a stressful family gathering. She had a history of progressive difficulty bending forward and increasing lumbar lordosis.
Investigations:
Physical examination, spine MRI scan, abdominal and pelvic ultrasound, electromyogram, nerve conduction studies, cerebrospinal fluid analysis, breast examination, Pap smear, transabdominal and endovaginal ultrasound.
Diagnosis:
Stiff-person syndrome with high titer of antibodies against glutamic acid decarboxylase.
Treatment:
Benzodiazepines and intravenous immunoglobulins.
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