A STIFF BACK
34 yr old man with recurrent backache and stiffness for last 04 yrs, variably treated with analgesics, local intrathecal inj., physiotherapy with little relief.
Patient unable to bend forward with mild proximal weakness. Reflexes normal
CPK mildly elevated 306IU/L.
EMG/NCS- low motor nerve amplitude in lower limbs. EMG showed continuous motor unit activity even at rest and myokymic discharges lower limbs.
Immunological assessment including antineuronal Ab performed at our lab:
Anti GAD stiff person syndrome.
A simple treatment with oral baclofen and steroid resolved the chronic spasm and patient can now easily perform his daily work.