罕见的神经系统疾病病例报告:抗GAD抗体阳性的Moersch-Woltman综合征。

International journal of medical students Pub Date : 2023-09-29 Epub Date: 2023-09-15
Aakanksha Pitliya
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引用次数: 0

摘要

背景:莫氏-沃尔特曼综合征(MWS),也称为僵硬人综合征(SPS),是一种罕见的中枢神经系统进行性疾病。症状可能包括严重的不动、僵硬和躯干和四肢疼痛的肌肉痉挛。MWS患者可能会出现肌肉痉挛,因为他们对噪音、快速运动和精神障碍更敏感。这种情况对女性的影响是男性的两倍。这是一种罕见的疾病,每百万人中只有1-2人感染。该病例报告旨在强调与MWS相关的诊断挑战的重要性以及谷氨酸脱羧酶(GAD)抗体的重要性。病例:一名57岁女性患者,有偏头痛、焦虑和抑郁病史。患者经历了广泛而痛苦的肌肉痉挛,影响肩部、上背部和下背部,颈部活动范围有限。体格检查显示全身肌肉致密、弥漫性僵硬。下令进行进一步调查,包括全面的实验室测试和成像测试。GAD抗体的阳性检测证实了MWS的诊断。治疗包括服用氯硝西泮和巴氯芬。三周后的随访显示痉挛明显减轻了15-20%。结论:本病例强调了抗GAD抗体在确认SPS诊断中的关键作用。医疗保健专业人员应考虑在出现上述症状的患者身上检测这些抗体。涉及神经科医生、物理治疗师、精神科医生和整形外科医生的多学科方法对于为MWS患者提供全面护理和优化结果至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Rare Case Report of Neurological Condition: Moersch-Woltman Syndrome with Positive Anti-GAD Antibodies.

Background: Moersch-Woltman Syndrome (MWS), also known as Stiff person syndrome (SPS), is a rare, progressive condition of the central nervous system. Symptoms can include severe immobility, rigidity, and painful muscle spasms in the trunk and limbs. Muscle spasms can occur in MWS patients because they are more sensitive to noise, rapid movements, and mental disturbance. The condition affects women twice as frequently as it does males. It is a rare disease, affecting only 1-2 people per million. The case report aims to highlight the importance of the diagnostic challenges associated with MWS and the significance of glutamic acid decarboxylase (GAD) antibodies.

The case: A 57-year-old female patient presents with history of migraine headaches, anxiety, and depression. The patient experienced widespread and distressing muscle spasms affecting the shoulders, upper and lower back, and limited range of motion in the neck. Physical examination revealed dense diffuse muscle stiffness throughout the body. Further investigations were ordered, including a comprehensive range of laboratory tests and imaging tests. A positive test for GAD antibodies confirmed the diagnosis of MWS. Treatment included administration of Clonazepam and Baclofen. A follow-up appointment, three weeks later, indicated a noticeable 15-20% reduction in spasticity.

Conclusion: This case highlights the crucial role of anti-GAD antibodies in confirming the diagnosis of SPS. Healthcare professionals should consider testing for these antibodies in patients presenting with the described symptoms. A multidisciplinary approach involving neurologists, physical therapists, psychiatrists, and orthopedic surgeons is essential to provide comprehensive care and optimizing outcomes for individuals with MWS.

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