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Abstract

Stiff person syndrome is characterized by muscle rigidity that waxes and wanes along with concurrent spasms. The closest related disease to Stiff person syndrome is Tetanus because both conditions affect peripheral inhibition via central mechanisms and both conditions inhibit central gamma-amino butyric acid (GABA) systems. We herein report the case of stiff-person syndrome in a 65-year-old man. He experienced pain with bleeding from the rectum. The tests included screening tests to detect the presence of amphiphysin antibodies and electromyography. His clinical examination was suggestive of generalized muscle involvement with laryngeal involvement. He was evaluated with a CT scan abdomen, which was suggestive of Liver Limited cancer and rectal examination suggested ulcero-proliferative growth of around 4 cm from the anal verge. Colonoscopy was suggestive of circumferential growth with multiple session polyps, which was to document the metastatic nature of the disease. FNAC was done from the government which was conclusive of metastasis. He was initiated on Capecitabine7 and Oxaliplatin protocol. He underwent NCV studies which came out to be mild to the moderate sensory deficit. During the hospital stay, he was treated with high dose Methyl Prednisolone 1gm for 5 days and sequentially with immunoglobulin 2gm per day for 5 days, concomitantly Benzodiazepam was given 10mg three times a day for 3 days but later withdrawn as the patient started experiencing dizziness. He achieved no clinical benefit in neurological status. Eventually developed aspiration pneumonia and succumbed to death after one month of diagnosis of SPS.

Keywords

Stiff-person syndrome Autoimmune Disorder Methyl Prednisolone Bevacizumab

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