1. After several years of progressively worsening symptoms, starting with intermittent muscular rigidity and spasms in the lower back, this patient now has stiff leg muscles (more pronounced on the right side). On exam, she demonstrates a slow, stiff manner of walking and lordosis of the lower spine.
Diagnosis: Moersch-Woltman syndrome, or stiff person syndrome, is a rare acquired neurologic disorder, affecting both men and women of any age; most, however, are women. Thought to be an autoimmune disorder, this syndrome may localized to one area of the body or may be widespread, and rapidly progressive, including the body, brain stem, and spinal cord. If untreated, the patient may have difficulty walking and performing activities of daily living.
For more information, see “Stiff Person Syndrome.”