Display options
Cite
Cervantes CE, Lee Lau H, Binazir TA, et al. Why It Is Not Always Anxiety: A Tough Diagnosis of Stiff Person Syndrome. Case Rep Neurol Med. 2017;2017:7431092doi: 10.1155/2017/7431092.
Cervantes, C. E., Lee Lau, H., Binazir, T. A., O'Brien, K. O., & Cross, J. S. (2017). Why It Is Not Always Anxiety: A Tough Diagnosis of Stiff Person Syndrome. Case reports in neurological medicine, 20177431092. https://doi.org/10.1155/2017/7431092
Cervantes, Carmen Elena, et al. "Why It Is Not Always Anxiety: A Tough Diagnosis of Stiff Person Syndrome." Case reports in neurological medicine vol. 2017 (2017): 7431092. doi: https://doi.org/10.1155/2017/7431092
Cervantes CE, Lee Lau H, Binazir TA, O'Brien KO, Cross JS. Why It Is Not Always Anxiety: A Tough Diagnosis of Stiff Person Syndrome. Case Rep Neurol Med. 2017;2017:7431092. doi: 10.1155/2017/7431092. Epub 2017 Aug 14. PMID: 28890837; PMCID: PMC5584351.
Copy Download .nbib Format: NLM
Share it on

Case Rep Neurol Med. 2017;2017:7431092. doi: 10.1155/2017/7431092. Epub 2017 Aug 14.

Why It Is Not Always Anxiety: A Tough Diagnosis of Stiff Person Syndrome.

Case reports in neurological medicine

Carmen Elena Cervantes, Hsien Lee Lau, Tina Ataian Binazir, Keith O O'Brien, Jonathan S Cross

Affiliations

  1. Department of Medicine, Aventura Hospital and Medical Center, Aventura, FL, USA.

PMID: 28890837 PMCID: PMC5584351 DOI: 10.1155/2017/7431092

Abstract

Anxiety disorder is a commonly used diagnosis that may mask underlying conditions. Stiff person syndrome (SPS) is a rare neuroimmunological disorder characterized by progressive rigidity and painful muscle spasms affecting axial and lower extremity musculature. These episodes can be triggered by sudden movement, noise, or emotional stress, which may present as a psychiatric condition. We report the case of a 30-year-old female who presented with recurrent panic attacks with multiple prior hospital admissions for anxiety, rigidity, and difficulty in walking. Previous electroencephalogram (EEG) and brain and cervical spine magnetic resonance imaging (MRI) were unremarkable. She was empirically treated with diazepam and beta-blockers for SPS, which was confirmed by positive glutamic acid decarboxylase (GAD) antibodies. The patient's symptoms became refractory to benzodiazepines and required steroids with intravenous immunoglobulin (IVIG). Her rigidity subsequently responded to plasmapheresis. In SPS, antibodies in the cerebrospinal fluid (CSF) most commonly target the GAD antigen on gamma-aminobutyric acid (GABA) neurons. The goal of treatment is to ameliorate symptoms and improve quality of life. Our case of SPS was masked as generalized anxiety disorder for at least six years since onset of symptoms. The criteria for both diagnoses may overlap as seen in this patient.

References

  1. Neurosciences (Riyadh). 2016 Jul;21(3):215-22 - PubMed
  2. JAMA Neurol. 2015 Aug;72(8):874-81 - PubMed
  3. Cureus. 2015 Dec 22;7(12):e427 - PubMed
  4. Transfusion. 1999 Mar;39(3):282-8 - PubMed
  5. JAMA Neurol. 2013 Sep 1;70(9):1140-9 - PubMed
  6. Neurology. 2000 Nov 28;55(10):1531-5 - PubMed
  7. Lancet. 2014 Feb 15;383(9917):668 - PubMed
  8. Transfusion. 2014 Jul;54(7):1851-6 - PubMed
  9. Int J Eat Disord. 2011 Apr;44(3):284-6 - PubMed
  10. Clin Neurol Neurosurg. 2009 Sep;111(7):644 - PubMed
  11. Pract Neurol. 2011 Oct;11(5):272-82 - PubMed
  12. J Neurol Neurosurg Psychiatry. 2015 Aug;86(8):840-8 - PubMed
  13. Curr Treat Options Neurol. 2009 Mar;11(2):102-10 - PubMed

Publication Types