Session Information
Session Title: AA 2021 Virtual Posters - Pain and Spine Medicine
Session Time: None. Available on demand.
Disclosures: Vincent Yaccarino, MD: No financial relationships or conflicts of interest
Case Diagnosis: Stiff Person Syndrome
Case Description: The patient presented to a spine clinic with a several year history of low back pain with right-sided L5 radiculopathy causing weakness and numbness and left-sided radicular pain. A CT L-spine was ordered which showed bilateral L5-S1 neural foraminal narrowing. However, prior to obtaining CT results, the patient noted increased episodes of tripping and new stiffening sensations with cramping of the right leg. Due to lack of findings on initial studies, she was referred to multiple specialists and had other studies including labs, spinal tap, EMG, MRI of the brain and total spine. Throughout this workup, the patient was progressively worsening with increasingly frequent right leg stiffening episodes and cramping, persistent increased tone in the right lower extremity, and difficulty walking. Upper motor neuron signs including clonus and brisk reflexes developed. After an exhausting workup, anti-glycine antibodies returned positive and she was diagnosed with stiff person syndrome.
Setting: Tertiary Care HospitalAssessment/
Results: She is being successfully treated with IVIG infusions, baclofen and bracing. Botox is being considered.
Discussion: Stiff person syndrome is an exceedingly rare condition with a prevalence of 1-2 cases per million. Of which, partial stiff person syndrome, as in this case, is noted in about 10-15% of patients. The extreme rarity of the condition often makes diagnosis difficult and delayed. Given the progression of unilateral neurological symptoms, it can first present in a spine clinic due to concerns for radiculopathy.
Conclusion: Stiff person syndrome is a rare disorder which can present initially to a spine clinic as early signs can mimic spine pathology.
Level of Evidence: Level V
To cite this abstract in AMA style:
Yaccarino V, Wallace SA, Suer M. Lumbar Radiculopathy to Partial Stiff Person Syndrome: A Case Report [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/lumbar-radiculopathy-to-partial-stiff-person-syndrome-a-case-report/. Accessed May 12, 2025.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/lumbar-radiculopathy-to-partial-stiff-person-syndrome-a-case-report/