Stiff-Person syndrome and generalized anxiety disorder

Cerqueira, Ana Cláudia Rodrigues de; Bezerra, José Marcelo Ferreira; Rozenthal, Márcia; Nardi, Antônio Egídio

doi:10.1590/s0004-282x2010000400036

Cited by 8 publications

(7 citation statements)

References 7 publications

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“…12 Early recognition of stressors is essential in developing a strategy to effectively manage and reduce the risk of falls. A prior case report 13 of a 51-year-old female with progressing SPS and generalized anxiety disorder has supported the hypothesis that the use of benzodiazepines is effective by enhancing GABAergic inhibitory transmission. Although there are confounding factors, it is thought that the increased frequency of clonazepam use in this patient resulted in improvement of the patient's symptoms with less frequency of stiffness and anxiety.…”

Section: Discussionmentioning

confidence: 73%

Stiff-person syndrome in a patient with comorbid bipolar and panic disorders: A case report and literature review

Patel¹,

Stummer²,

Patel³

2020

Mental Health Clinician

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Stiff-person syndrome (SPS) is a neurologic disorder characterized by muscle stiffness, rigidity, and muscle spasms, and it can increase a patient's risk for falls. It is recognized as a rare disease with limited clinical guidelines to manage the condition and its symptoms. Currently, there is even less clinical guidance for the management of common comorbid conditions in these patients. This patient case report aims to evaluate the efficacy of various medications for symptom management in a patient with SPS and comorbid psychiatric disorders, specifically bipolar I and panic disorder. Throughout the patient's course of treatment, various medications were trialed, including fluoxetine, hydroxyzine, valproic acid, propranolol, and clonazepam. Ultimately, fluoxetine, hydroxyzine, and propranolol were discontinued due to adverse drug reactions and incomplete symptom resolution. The patient's bipolar I disorder was adequately managed with valproic acid. Once the clonazepam was changed from as-needed to scheduled dosing, the patient's panic disorder and anxiety-triggered spasms were well controlled. The efficacy of benzodiazepines, specifically high doses of diazepam, in alleviating muscle spasms and anxiety in SPS has been demonstrated in the literature. Case reports including patients with SPS that are prescribed selective serotonin reuptake inhibitors provide controversial evidence as some studies report exacerbation of SPS symptoms with prolonged use. As this case report and literature review suggest, patients with SPS and comorbid panic disorder and anxiety-triggered spasms may benefit from the use of benzodiazepines. The use of other medication classes for the treatment of other comorbid psychiatric disorders in a patient with SPS is lacking evidence.

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Section: Discussionmentioning

confidence: 73%

Stiff-person syndrome in a patient with comorbid bipolar and panic disorders: A case report and literature review

Patel¹,

Stummer²,

Patel³

2020

Mental Health Clinician

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“…This in turn can lead to anticipatory anxiety in situations which the patient believes to be unsafe. [42] …”

Section: Clinical Features and Course Of Spsmentioning

confidence: 99%

“…[43] Panic disorder, post-traumatic stress disorder, generalised anxiety disorders and phobic disorders are frequently associated with SPS. [42,44] Other conditions usually associated with SPS include depression and substance abuse, [42] which have both been linked to dysregulation in the GABA system. [4] Conversion disorder can also occur in association with SPS.…”

Section: Psychiatric Conditions Associated With Spsmentioning

confidence: 99%

Stiff person syndrome (SPS): Literature review and case report

Pretorius

Struwig

2013

S Afr J Psych

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“…Os espasmos são frequentemente desencadeados por sensações e emoções como medo, estímulo tátil ou auditivo inesperado [3]. Sintomas autonômicos como taquicardia, hiperidrose, alterações da pressão arterial, constipação e retenção urinária acompanham os espasmos [6].…”

Section: Introductionunclassified

Rhizotomy and endoscopic discectomy for chronic low back pain and acute radiculopathy in a stiff-person syndrome - case report

Araújo¹,

Araújo²,

Morete³

et al. 2022

CPAH

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INTRODUCTION: Stiff Person Syndrome (SPS) is a rare neurological disorder, first described in 1956 by Moersch and Woltman. The clinical picture has an insidious onset of classic findings of episodic painful spasms, hyperreflexia, axial muscle stiffness, progressing slowly to the proximal limb muscles. Painful hyperlordosis due to lumbar spine stiffness is a diagnostic characteristic of SPS. CASE REPORT: Male, 69 years old, with SPS for 40 years, referred by the neurologist to the spine surgeon because of failure to conservative management of chronic low back pain, progressively acute leg and gait impairment. Physical examination is difficult to perform in SPS because it triggers spasms. MRI presented zygoapophyseal joint, intervertebral discs and muscle degeneration, including a L4L5 cranial migrated herniated disc. Once there were no other effective ways to manage his axial and radicular pain, it was decided to perform percutaneous transforaminal endoscopic discectomy for L4L5 decompression, L3 to S1 dorsal ganglion root medial branch ablative radiofrequency rhizotomy to relieve facet pain and L2 dorsal sensory ganglion pulsed radiofrequency rhizotomy for modulation of chronic low back pain. One year postoperative follow up, the patient has showed improvement in the VAS and SF-36. CONCLUSION: Chronic pain reported by a patient must be addressed in the biological, psychological and social dimensions. Understanding the multidimensionality of the factors involved with pain allows planning less aggressive and highly efficient strategies in uncommon and off label patients, as in the case of SPS.

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Stiff-Person syndrome and generalized anxiety disorder

Cited by 8 publications

References 7 publications

Stiff-person syndrome in a patient with comorbid bipolar and panic disorders: A case report and literature review

Stiff-person syndrome in a patient with comorbid bipolar and panic disorders: A case report and literature review

Stiff person syndrome (SPS): Literature review and case report

Rhizotomy and endoscopic discectomy for chronic low back pain and acute radiculopathy in a stiff-person syndrome - case report

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