Acute ataxia, Graves' disease, and stiff person syndrome.
Stiff person syndrome (SPS) has been associated with autoimmune diseases, such as Type 1 diabetes mellitus and autoimmune thyroid disease (Hashimoto's thyroiditis), among others. The association of SPS with hyperthyroidism is extremely rare. We describe a patient with uncontrolled Graves' disease and undiagnosed SPS, who presented initially with acute ataxia simulating a cerebrovascular accident. Initiation of immunosuppressive therapy dramatically improved the patient's Graves' disease within 2 weeks but the neurological symptoms were not alleviated after a follow-up period of 3 years.
Chia
Su-Ynn
SY
Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore.
Chua
Richard
R
Lo
Yew-Long
YL
Wong
Meng-Cheong
MC
Chan
Ling-Ling
LL
Tan
Eng-King
EK
D013956:Antithyroid Agents / Q000008:administration & dosage; D001259:Ataxia / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D001323:Autoantibodies / Q000097:blood; D002231:Carbimazole / Q000008:administration & dosage; D003131:Combined Modality Therapy; D015897:Comorbidity; D003937:Diagnosis, Differential; D004576:Electromyography; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D006111:Graves Disease / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D006801:Humans; D007116:Immunization, Passive; D007165:Immunosuppression Therapy; D008875:Middle Aged; D009460:Neurologic Examination; D010956:Plasmapheresis; D016750:Stiff-Person Syndrome / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D020521:Stroke / Q000175:diagnosis; D013971:Thyrotoxicosis / Q000175:diagnosis / Q000276:immunology / Q000628:therapy
D013956:Antithyroid Agents; D001323:Autoantibodies; D002231:Carbimazole; D005968:Glutamate Decarboxylase