title: Stiff person syndrome presenting with sudden onset of shortness of breath and difficulty moving the right arm: a case report.
abstract: BACKGROUND
  First described in 1956, stiff person syndrome is characterized by episodes of slowly progressive stiffness and rigidity in both the paraspinal and limb muscles. Although considered a rare disorder, stiff person syndrome is likely to be under-diagnosed due to a general lack of awareness of the disease in the medical community.
  
  
  METHODS
  A 27-year-old Hispanic woman presented to our emergency department with a sudden onset of shortness of breath and difficulty moving her right arm. Her physical examination was remarkable in that her abdomen was firm to palpation and her right upper extremity was rigid on passive and active ranges of motion. Her right fingers were clenched in a fist. Her electromyography findings were consistent with stiff person syndrome in the right clinical setting. Stiff person syndrome is confirmed by testing for the anti-glutamic acid decarboxylase antibody. Her test for this was positive.
  
  
  CONCLUSIONS
  Stiff person syndrome may not be a common condition. However, if disregarded in the differential diagnosis, it can lead to several unnecessary tests being carried out causing a delay in treatment. This case report reveals some of the characteristic features of stiff person syndrome with an atypical presentation.
authors.affiliation: Department of Family and Community Medicine, University of Nevada School of Medicine, Fire Mesa Street, Las Vegas, Nevada 89128, USA. kmartin@medicine.nevada.edu.
authors.forename: Bradley
authors.initials: B
authors.lastname: Goodson
authors.forename: Kate
authors.initials: K
authors.lastname: Martin
authors.forename: Thomas
authors.initials: T
authors.lastname: Hunt