Stiff-Person Syndrome: A Case Report and Treatment Modalities

Stiff-person syndrome (SPS) is a rare autoimmune neurologic disorder characterized by fluctuating muscle rigidity and painful spasms. It is often refractory to standard therapies such as benzodiazepines, baclofen, and intravenous immunoglobulin (IVIG). We present the case of a 64-year-old African American female with SPS who experienced limited relief from opioids, muscle relaxants, IVIG, and a single intrathecal baclofen dose. Following intramuscular onabotulinumtoxinA (Botox) injections, she reported marked improvement in rigidity, posture, gait, and activities of daily living, with relief lasting approximately three months per session and no significant adverse effects. This case highlights the potential role of Botox as a safe and effective adjunctive therapy in the symptomatic management of SPS, warranting further research into its long-term efficacy and integration into treatment strategies for refractory cases.