Stiff Person with Anti-GAD Antibodies

Abstract

Stiff Person Syndrome (SPS) is a rare autoimmune disease related to the lack of inhibition of excitatory neurons in the central nervous system leading to multiple motor dysfunction and symptoms due to uncontrolled motor neuron firing. The pathophysiology of the disease is not completely understood; however, high titers of Glutamic acid decarboxylase antibodies (anti-GAD Ab) have been found in such patients, which leads to its high association with the disease. We present a case of a 52-year-old female with a 20-year history of ongoing gait and balance issues. She is diagnosed with multiple conditions, including stiff person syndrome (GAD+), spinocerebellar ataxia with epilepsy, systemic lupus erythematosus, type 1 diabetes mellitus, IgA deficiency, hypothyroidism, and pernicious anemia. She presented in our institution with a history of a recent fall from a wheelchair. We review the case presentation and association of anti-GAD antibodies with stiff person syndrome and its treatment.