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Unusual presentation of stiff-person syndrome in a patient with type 1 diabetes mellitus
  1. Bala Munipalli and
  2. Jaimin S Shah
  1. Mayo Clinic Hospital, Jacksonville, Florida, USA
  1. Correspondence to Dr. Bala Munipalli; Munipalli.Bala{at}


Stiff-person syndrome (SPS) is a rare, autoimmune, neurological disorder that often occurs concurrently with other autoimmune disorders, such as type 1 diabetes mellitus, pernicious anaemia, vitiligo and Hashimoto’s thyroiditis. It also can manifest as a paraneoplastic syndrome. Although SPS classically presents with truncal and appendicular stiffness and lumbar hyperlordosis, it can present focally in a single limb (termed stiff-limb syndrome). Here, we describe a woman with stiff-limb syndrome who initially presented with concerns about right foot swelling and pain. She also was positive for anti-GAD65 (anti-GAD2) antibodies. With treatment, she regained the ability to drive and ambulate without a walker, and she had a noted reduction in stimulus-induced spasms.

  • diabetes
  • neurology

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  • Contributors BM: conceptualisation, visualisation, writing—original draft, writing—review and editing. JSS: writing—review and editing, resources, expertise (specialist in neuromuscular neurology, follow-up of patient outcomes with treatment).

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.