Stiff-person syndrome revealed by auto-immune diabetes: A case report at the Yaoundé General Hospital

Abstract

Stiff Person Syndrome (SPS) is a rare neurological disorder, characterized by progressive muscle stiffness, rigidity, and painful spasms, involving the axial and limb muscles. This is often triggered by tactile or emotional stimuli. It is typically associated with autoantibodies against glutamic acid decarboxylase (GAD65), which impair inhibitory neurotransmission in the central nervous system. We report the case of a 56‑year‑old patient, who was diagnosed with an inaugural hyperglycemic decompensation, revealing diabetes with ketosis without acidosis. One month later, he developed stiffness of the thorax, abdomen and all four limbs, with generalized muscle spasms, leading to repeated falls. Electroneuromyography showed a sensorimotor polyneuropathy. Anti‑glutamate decarboxylase isoform 65 (GAD65) antibodies were positive. The outcome under treatment was rapidly favorable. Although rare, Stiff Person Syndrome should be considered as a differential diagnosis in patients presenting with autoimmune diabetes and symptoms of spasticity.