Resolution of Stiff-Man Syndrome with Cortisol Replacement in a Patient with Deficiencies of ACTH, Growth Hormone, and Prolactin

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Abstract
THE stiff-man syndrome is an unusual affliction of adults that is characterized by progressive stiffness and painful muscle spasms affecting the axial and limb musculature, with an electromyographic pattern of continuous motor activity at rest.1 The cause of this disorder is not known, but it has been associated with diabetes2 and with thyrotoxicosis.3 Treatment of these endocrine disturbances has not relieved the neuromuscular symptoms. We describe a patient with clinical and electrophysiologic features of stiff-man syndrome associated with deficiencies of adrenocorticotropic hormone (ACTH), growth hormone, and prolactin, whose stiffness resolved with cortisol-replacement therapy.Case ReportA 42-year-old woman was in . . .