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

Stiff person syndrome is a rare neurologic disorder with an estimated incidence of 1:1000000. 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.