title: Anesthetic management of a parturient with Stiff person syndrome for urgent cesarean delivery.
abstract: Stiff person syndrome is a rare neurologic disorder with an estimated incidence of 1:1000000. The underlying pathophysiology is truncal and proximal limb muscle stiffness resulting from continuous co-contracture of agonist and antagonist muscle groups concomitant with superimposed episodic muscle spasms. Loss of gamma-aminobutyric acid-mediated inhibition creates chronic excitation manifested by tonic agonist-antagonist muscle contraction. To date, only three case reports referred indirectly to the anesthetic management of parturients with Stiff person syndrome. The authors describe their management of a parturient with Stiff person syndrome who underwent urgent cesarean delivery under epidural anesthesia.
authors.affiliation: Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: bboettcher@mcw.edu.
authors.forename: B T
authors.initials: BT
authors.lastname: Boettcher
authors.affiliation: Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: M
authors.initials: M
authors.lastname: Muravyea
authors.affiliation: Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: C
authors.initials: C
authors.lastname: Kuo
authors.affiliation: Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: C
authors.initials: C
authors.lastname: Drexler
authors.affiliation: Anesthesia Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Pagel
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D002585:Cesarean Section; D004630:Emergencies; D005260:Female; D006801:Humans; D011247:Pregnancy; D016750:Stiff-Person Syndrome / Q000150:complications*
keywords: Cesarean delivery; Epidural anesthesia; Gamma-aminobutyric acid; Glutamic acid decarboxylase; Stiff person syndrome