Stiff person syndrome and type 1 diabetes in pregnancy

Abstract

Stiff Person Syndrome (SPS) is a rare autoimmune neurological disorder linked to anti-GAD antibodies, marked by muscle rigidity, spasms, and heightened sensitivity to stimuli, predominantly affecting axial muscles. Managing SPS during pregnancy is complex and necessitates a multidisciplinary approach. This case report details the management of a 32-year-old pregnant woman with SPS and type 1 diabetes mellitus. Diagnosed 10 years prior to pregnancy, her SPS was managed with intravenous immunoglobulin, diazepam, and baclofen. During pregnancy, adjustments were made to minimise potential risks; diazepam was replaced with clonazepam near delivery to support breastfeeding, and IVIG dosing was modified based on symptoms. Her type 1 diabetes remained well controlled with an insulin pump. Delivery planning addressed risks of SPS spasms, shoulder dystocia, and caesarean recovery. This case highlights the importance of individualised care and collaboration among specialists in managing pregnancy with SPS.