A 28-year-old woman presented to hospital after an episode of severe lower back spasms that occurred during a stressful family gathering. She had a history of progressive difficulty bending forward and increasing lumbar lordosis.Investigations
Physical examination, spine MRI scan, abdominal and pelvic ultrasound, electromyogram, nerve conduction studies, cerebrospinal fluid analysis, breast examination, Pap smear, transabdominal and endovaginal ultrasound.Diagnosis
Stiff-person syndrome with high titer of antibodies against glutamic acid decarboxylase.Treatment
Benzodiazepines and intravenous immunoglobulins.