The case centres on
a 26-year-old male patient who was admitted to the General Medicine ward for a
non-life-threatening ailment. In the previous three days, this patient had had
excruciating spasms and stiffness in both legs. The patient was unable to stand
up without difficulty as a result of this complaint, and as a result, was
unable to walk correctly. He had no history of animal or insect bites or
wounds, and his legs were free of infected sores or abscesses. The patient
explained that his employment needs him to stand for lengthy periods of time in
hot temperatures when asked. However, his symptoms seemed to intensify and
spread over time. As a result, he was taken to the General Medicine ward for
heat stroke. with
rhabdomyolysis. His renal function tests were normal, and his CK levels were
> 2000 IU/l.
Overall, the patient
appeared stable and fully conscious, well-oriented to time and place, and
afebrile. However, he seemed to resist movement and therefore looked rigid in
his overall appearance. However, (to avoid using ‘however’ again, you could
start with: ‘Despite this, his…’) his symptoms greatly improved to the point of
nearly disappearing when he was resting or asleep. The patient also had to be shifted to the ICU
to stabilize his muscle stiffness, where he developed a few complications such
as acute kidney injury, severe lactic acidosis, desaturation, tachycardia, and
reduced urine output. In the middle of all this, (Or: ‘During all this,’) there
was no abnormality seen in neuroimaging or from electrophysiological studies.
However, the raised level of anti-GAD antibodies combined with the patient's
history and examination findings all pointed towards the patient suffering from
Stiff Person Syndrome (SPS). However, since this case was already proving to be
both complicated and difficult to diagnose, there must be (or ‘needs to be’) a
systematic way of ruling out the other possible causes of the symptoms and the
complications that arise in a given patient to make sure that there are no
errors in diagnosing the case or intervening accordingly. Failure to do so can
complicate the condition and deteriorate the patient’s condition further.
Therefore, this case study aims to target those areas that point towards
diagnosing this condition early and in a better way. This study also focuses on
the possible treatment and management plans that should be systematically
carried out on suspected patients of Stiff Person Syndrome to ensure their
timely survival and to prevent complications electrophysiological research The
patient's history and physical results, together with the patient's elevated
anti-GAD antibodies, all pointed to the patient having Stiff Person Syndrome
(SPS). However, because this case was already proving to be complicated and
difficult to identify, there must be (or 'needs to be') a systematic manner of
ruling out other probable causes of symptoms and problems in a specific patient
to ensure that no errors in diagnosing or intervening are made. Failure to do
so may aggravate the situation and worsen the patient's condition. As a result,
the goal of this case study is to focus on the aspects that indicate to
identifying this problem earlier and more accurately. This research also looks
at various therapy and management strategies that should be used on suspected Stiff
Person Syndrome patients in order to ensure their timely survival and avoid
complications.
Author(S)
Details
Ashraf ALakkad
Department of
Internal Medicine, Madinat Zayed Hospital, United Arab Emirates.
Mahmoud Sami
Department of Critical Care, Madinat Zayed Hospital, United Arab Emirates.
Mohamed Salah
Department of Neurology, Madinat Zayed Hospital, United Arab Emirates.
View Book:- https://stm.bookpi.org/NHMMR-V9/article/view/6908
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