Anesthesia considerations in stiff person syndrome.

A 34 year old morbidly obese stiffperson syndrome (SPS) patient was scheduled for a permanent catheter placement. SPS is a rare neurologic condition with a suspected autoimmune etiology. SPS most common manifestations are progressive, including severe muscle rigidity or stiffness affecting the spine and lower extremities more than other muscle groups. SPS have superimposed episodic muscle spasms that may resemble myotonic-like contractions and are precipitated by unexpected noises, tactile stimuli, or emotional stress. This case report describes a patient with SPS and morbid obesity, and his subsequent management perioperatively for a permanent catheter placement under monitored anesthesia care. Careful and methodical management of patients with SPS is strongly suggested given their sensitivity to inhalational anesthetics and neuromuscular blockers.