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47-year-old woman can’t walk with a backache! Neurology expert: This disease is very easy to misdiagnose! Three months ago, international star Celine Dion, who sang “My Heart Will Go On,” the theme song of the movie Titanic, announced that she had stiff man syndrome, which attracted wide attention from fans. But many people do not know much about “stiff person syndrome”. Today, we will use Ms. Liang’s medical experience to popularize “stiff person syndrome”. Two years of rough medical treatment, Ms. Liang, 49 years old, from Tongcheng City, Anhui Province. Two years ago, her waist and legs began to ache, and she felt stiff in her waist and could not bend down. As time went on, the pain gradually increased, and later it was difficult to walk. Accompanied by her husband, they began to rush around in a number of third-class hospitals, successively in orthopaedics, Rheumatology and immunology, hand and foot surgery, neurology and so on, but the diagnosis was quite different, “some said it was lumbar disc herniation, some said it was ankylosing spondylitis, and some said it was menopausal syndrome, somatoform disorders and so on”. For this reason, Ms. Liang has also received a variety of treatments, including lumbar disc herniation surgery, anti-inflammatory pain relief, emotional regulation and so on, but after a series of treatments, the symptoms have not improved, but become more and more serious. Suffering from illness, she was originally cheerful, but gradually became introverted and withdrawn. In April 2022, on the recommendation of a friend, Ms. Liang and her husband came to the Department of Neurology of the First Affiliated Hospital of China University of Science and Technology with a “try” mentality. The neurologist patiently soothed Ms. Liang’s mood and carefully inquired about her symptoms. According to the characteristics of Ms. Liang’s medical history, she perfected electromyography, lumbar puncture, GAD65 antibody detection and other examinations, and finally, Ms. Liang was diagnosed with an extremely rare disease-stiff person syndrome. Yu Feng introduced that stiff-person syndrome (SPS) is an extremely rare autoimmune disease of the central nervous system, with an incidence of about 1-2/1 million. It often occurs in women aged 20-50. The initial symptoms are stiffness and spasm of trunk and limb muscles. This kind of muscle spasm pain is usually induced or aggravated by the stimulation of sound, light, touch, emotion, etc. In view of Ms. Liang’s condition and the actual situation of her family’s financial difficulties, an individualized treatment plan was adopted for her: clonazepam + pregabalin, while methylprednisolone impact combined with cyclophosphamide treatment, the patient’s limb stiffness and pain disappeared and could walk independently, after discharge, the patient was advised to visit the outpatient clinic regularly. At present, Ms. Liang is in stable condition and takes care of herself completely. To face the disease with a positive attitude, the symptoms of back muscle stiffness and pain are common in clinic, so stiff person syndrome is easily misdiagnosed as lumbar disc herniation, ankylosing spondylitis and other diseases. After repeated treatment, they may be diagnosed as somatization symptoms of depression and anxiety. Specialists warn that if the symptoms of waist and leg pain and stiffness are not treated well, we should be alert to the possibility of stiff person syndrome. Yu Feng pointed out that the existing medical morbidity mechanism for stiff person syndrome is not clear, in the trial use of various drugs and therapies, the course of patients is generally 4-20 years, and the final outcome is mostly bedridden. The decline of quality of life may bring great psychological pressure to patients with stiff-man syndrome, so the care of family members and the positive and optimistic attitude of patients themselves are very important. Experts say that many diseases in the field of neuroimmunity are rare diseases, including multiple sclerosis (MS), myasthenia gravis (MG), neuromyelitis optica spectrum disease (NMOSD), autoimmune encephalitis (AE), etc. These diseases have low incidence, difficult diagnosis and treatment, and are easy to recur. Common treatment options include glucocorticoids, immunosuppressants, immunoglobulins, plasma exchange or immunoadsorption, monoclonal antibodies and other treatment techniques. After regular diagnosis and treatment, most patients can achieve symptom improvement and good prognosis. The Department of Neurology of the First Affiliated Hospital of China University of Science and Technology has rich experience in the diagnosis and treatment of rare diseases of the neuroimmune system. Under the leadership of Professor Wang Guoping, the director of the Department, the “diagnosis and treatment of neuroimmune diseases” has been taken as the key direction of the sub-specialty construction of the Department. The discipline regularly carries out difficult case discussions and case sharing meetings, focusing on improving the clinical thinking and disease diagnosis and treatment ability of young doctors. The discipline has also participated in a number of national multi-center clinical drug trials and research on neuroimmune diseases, and has made good progress.
Stiff person syndrome
