Acupuncture as an Adjunct Treatment in Stiff Person Syndrome

Stiff person syndrome (SPS) is a rare neurological disorder. Treatments are limited, and non-pharmacologic therapies are recommended based on symptomatology. A G2P2002 post-menopausal 60-year-old female with hypertension, obesity, and type II diabetes, and SPS secondary to a paraneoplastic process cause by endometrioid ovarian adenocarcinoma who presented to acupuncture clinic seeking treatment for SPS and its sequela. Her main complaints upon presentation included muscles spasticity causing low back pain, hip flexor pain, insomnia and chemotherapy induced peripheral neuropathy. Her mood and quality of life were also noted to be poor at presentation.

A case report of implementation and customization of acupuncture treatment protocol for the sequelae of SPS including painful spasticity, insomnia, and reduced quality of life is discussed. Outcomes included measures of stiffness (degree of stiffness, distribution of stiffness, heightened sensitivity score) at each visit and health-related quality of life 14 item index at baseline. These outcomes were measured at the initiation of the acupuncture intervention (baseline) and after 9 weeks of weekly acupuncture treatments. These treatments included body acupuncture, electro acupuncture and auricular acupuncture. Acupuncture was performed in addition to her ongoing IVIG therapy.

Forward bending increased with maximal benefit observed by treatment 3. Lateral bending showed significant improvement with maximal effect by treatment 4. Timed activity testing (walk and stair climb) initially did not improve but showed a significant and sustained improvement following acupuncture protocol change following week 5. The self-rated quality of life outcome measure of overall health was unchanged ("good" at baseline and at follow-up), but all other quality of life outcome measures showed improvements.

SPS is a rare disorder causing substantial impairment for patients affected. The evidence supporting the use of acupuncture specifically for SPS is at most limited, however, the evidence supports the use of acupuncture for many of the symptoms experienced by those with SPS. This case illustrates how acupuncture can be considered as an adjunct therapy to improve the quality of life and function of these patients. More studies are needed to further investigate and optimize acupuncture treatment protocols for this rare disease.