Stiff limb syndrome, first case report in Palestine

Background

Stiff person syndrome (SPS) is a rare autoimmune neurological disorder characterized by progressive muscle rigidity and spasms. Stiff limb syndrome (SLS) is a rare, more localized variant of SPS.

Case presentation

This case report describes a 52-year-old woman who presented with a 2-year history of slowly progressive right leg stiffness causing severe spasms and difficulty in walking. Neurological examination showed severe spasticity of the right leg, increased deep tendon reflexes in all extremities, worse on the right leg and inability to stand due to the severity of the pain and spasticity of the right leg. Laboratory findings revealed elevated glutamic acid decarboxylase (GAD) antibodies, and positive pancreatic islet cells antibodies (ICA). Electromyography demonstrated continuous motor unit activity, that improved after administration of a benzodiazepine. The patient was treated with a benzodiazepine, which led to significant improvement in her symptoms.

Discussion

This article documented the first reported case of SLS in Palestine, highlighting the importance of early recognition and appropriate treatment of SLS to minimize functional impairment in patients. Detailed clinical features, laboratory findings, and the patient's response to therapy are discussed to emphasize the diagnostic challenges and management strategies for this rare neurological condition.