Anesthetic management of a parturient with Stiff person syndrome for urgent cesarean delivery

•Axial and limb stiffness and episodic spasms characterize Stiff person syndrome.•Anesthetic concerns of Stiff person syndrome include prolonged ventilation.•Both inhaled and intravenous anesthetic agents can produce muscular weakness.•Epidural anesthesia can be used in parturients with Stiff person syndrome.

Stiff person syndrome is a rare neurologic disorder with an estimated incidence of 1:1 000 000. The underlying pathophysiology is truncal and proximal limb muscle stiffness resulting from continuous co-contracture of agonist and antagonist muscle groups concomitant with superimposed episodic muscle spasms. Loss of gamma-aminobutyric acid-mediated inhibition creates chronic excitation manifested by tonic agonist-antagonist muscle contraction. To date, only three case reports referred indirectly to the anesthetic management of parturients with Stiff person syndrome. The authors describe their management of a parturient with Stiff person syndrome who underwent urgent cesarean delivery under epidural anesthesia.