Complexities in Managing Psychosis in a Patient With Stiff-Person Syndrome: A Case Report

Area of Science:

• Neurology
• Psychiatry
• Autoimmune Disorders

Background:

• Stiff-person syndrome (SPS) is a rare autoimmune neurological disorder causing muscle stiffness and spasms.
• Neurological symptoms can mimic psychogenic movement disorders, potentially delaying diagnosis.
• Psychiatric manifestations in SPS are less understood, with limited data on co-occurring conditions.

Observation:

• This case report details a 42-year-old female with SPS, multiple comorbidities (migraines, lupus, Sjogren's), and a psychiatric history.
• The patient presented with unspecified psychosis, paranoia, and atypical symptoms including sensory disturbances and chest pain.
• She exhibited resistance to certain psychiatric treatments, necessitating a multidisciplinary approach.

Findings:

• Psychosis in this SPS patient was managed with pharmacologic treatment, including aripiprazole.
• Psychotic symptoms resolved upon discharge, emphasizing the need for close outpatient follow-up.
• The case underscores the diagnostic and therapeutic complexities of managing psychosis in SPS with a complex medical and psychiatric profile.

Implications:

• This case enhances understanding of the clinical nuances at the intersection of SPS and psychiatric symptoms.
• It highlights the importance of a multidisciplinary approach for managing complex SPS cases with psychiatric comorbidities.
• Findings contribute to developing more effective management strategies for SPS-associated psychiatric conditions.