PDF(Pubmed)
Abstract：
Stiff-person syndrome (SPS) is an uncommon autoimmune neurological disorder marked by painful muscle stiffness, muscle spasms, and limb weakness. Neurological symptoms in SPS can mimic a psychogenic movement disorder in which symptoms are triggered by sudden movement and emotional distress, which might delay proper treatment. However, psychiatric symptoms are far less common, and there is limited understanding regarding the co-occurrence of psychiatric conditions. Psychiatric symptoms include nonspecific anxiety, agoraphobia, and depression, which can be triggered by sudden movement, noise, or emotional stress. This case report dives into the psychiatric manifestations seen in a patient with SPS. The case report focuses on a 42-year-old female with SPS, migraines, systemic lupus erythematosus, Sjogren\'s syndrome, and a psychiatric history of anorexia, depression, and anxiety. Her unique presentation underscored the necessity for a multidisciplinary approach to psychiatric care. The patient was evaluated and managed during her admission to the psychiatric unit for unspecified psychosis. Her course included a complicated medical evaluation for cardiovascular and neurologic symptoms and comprehensive psychiatric management. She manifested resistance to specific psychiatric medications and care strategies. She had atypical presentations, like sensory symptoms and left-sided chest pain. She exhibited paranoia and psychosis, which were managed with a combination of pharmacologic treatments, including aripiprazole. Psychotic symptoms were resolved upon discharge, with an emphasis on strict outpatient follow-up. This case report enhances our understanding of the clinical nuances associated with SPS and its intersection with psychiatric symptoms. The objective of this case report is to detail the diagnostic and therapeutic complexities of managing psychosis in a patient with SPS, along with a pre-existing complex medical and psychiatric profile, and to contribute to a deeper understanding of SPS and associated psychiatric conditions and more effective management strategies.
摘要：
僵硬人综合征（SPS）是一种罕见的自身免疫性神经系统疾病，其特征是疼痛的肌肉僵硬，肌肉痉挛,和四肢无力。SPS中的神经系统症状可以模仿一种心因性运动障碍，其中症状是由突然的运动和情绪困扰引发的，这可能会延误适当的治疗。然而,精神症状很少见，并且对精神病并发的理解有限。精神病症状包括非特异性焦虑，广场恐惧症,和抑郁症,它可以由突然的运动触发，噪音,或情绪压力。此病例报告深入研究了SPS患者的精神病表现。病例报告集中于一名42岁女性SPS患者，偏头痛,系统性红斑狼疮,干燥综合征,有厌食症的精神病史,抑郁症,和焦虑。她独特的演讲强调了多学科精神病治疗方法的必要性。患者在住院期间接受了未指明精神病的评估和管理。她的课程包括对心血管和神经系统症状的复杂医学评估以及全面的精神病管理。她表现出对特定精神病药物和护理策略的抵抗。她有非典型的演讲，比如感觉症状和左侧胸痛.她表现出偏执狂和精神病，通过药物治疗的组合进行管理，包括阿立哌唑.精神症状在出院后得到缓解，强调严格的门诊随访。此病例报告增强了我们对与SPS相关的临床细微差别及其与精神症状的交集的理解。本病例报告的目的是详细说明SPS患者管理精神病的诊断和治疗复杂性。以及预先存在的复杂的医学和精神病学档案，并有助于更深入地了解SPS和相关的精神疾病以及更有效的管理策略。
