2022 Volume 29 Issue 3 Pages 224-228
A woman in her 50s who had hyperthyroidism and antiphospholipid antibody syndrome, was brought to our hospital with a painful muscle spasm in her right thigh. She was unable to walk due to her painful muscle spasm and complained of anxiety about the muscle spasm. She was admitted to our hospital. On the fifth hospital day, she developed acute heart failure with suspected takotsubo cardiomyopathy. She was sedated with propofol and placed on a ventilator in the ICU. After she received intensive care and diazepam was administered, her muscle spasm disappeared, and the patient was extubated and discharged from the ICU. We diagnosed her with stiff-person syndrome (SPS) based on her clinical findings and strong positivity for anti-glutamic acid decarboxylase antibodies (anti-GAD antibodies) in her blood. SPS is a rare and intractable neurological disease characterized by muscle rigidity and muscle spasm. SPS can be caused by an autoimmune disorder associated with anti-GAD antibodies. In this case, the hyperexcitability of the sympathetic nervous system caused by anti-GAD antibodies and the psychological stress caused by anxiety and fear led to takotsubo cardiomyopathy. Our rigorous diagnostic approach and intensive care led to her good outcome.
