Management of refractory pain in Stiff-Person syndrome

Management of refractory pain in Stiff-Person syndrome

Stiff-Person syndrome (SPS) is a rare autoimmune neurological disorder characterised by episodic painful muscle rigidity and violent spasms. A significant trigger for the painful spasms experienced by patients is pain itself, making optimal pain management and avoidance a necessity. While first-line...

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Bibliographic Details
Published in:BMJ case reports Vol. 14; no. 1; p. e237814
Main Authors: Cirnigliaro, Frank Arthur, Gauthier, Nicole, Rush, Moira
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 11-01-2021
BMJ Publishing Group
Subjects:
Adult
Analgesia, Patient-Controlled - methods
Analgesics
Analgesics - administration & dosage
Antibodies
Anticonvulsants - administration & dosage
Case Report
Case reports
Female
Humans
Ketamine
Magnesium Sulfate - administration & dosage
Muscle Relaxants, Central - administration & dosage
Muscle Spasticity - diagnosis
Muscle Spasticity - drug therapy
Muscle Spasticity - etiology
Muscle Spasticity - rehabilitation
Narcotics
Pain management
Pain Management - methods
Pain Measurement
Pain, Intractable - diagnosis
Pain, Intractable - drug therapy
Pain, Intractable - etiology
Pain, Intractable - rehabilitation
Quality of life
Severity of Illness Index
Stiff-Person Syndrome - complications
Stiff-Person Syndrome - diagnosis
pain (neurology)
pain
drugs: CNS (not psychiatric)
neurology (drugs and medicines)
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Description
Summary:Stiff-Person syndrome (SPS) is a rare autoimmune neurological disorder characterised by episodic painful muscle rigidity and violent spasms. A significant trigger for the painful spasms experienced by patients is pain itself, making optimal pain management and avoidance a necessity. While first-line and second-line therapies for spasm prevention and termination are known, there is a paucity of evidence to guide pain management. We report the case of a 26-year-old woman with SPS referred for excruciating muscle cramping and rigidity with pain lasting beyond the episodes themselves. We report the novel use of ketamine and intravenous magnesium sulfate which may provide analgesia, spasm avoidance and early termination of exacerbations in SPS.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
ObjectType-Article-3
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-237814