A Pediatric Case of Stiff-Person Syndrome: Presentation and Comparative Analysis

Introduction: Stiff-person syndrome (SPS) is a rare autoimmune neurological disorder characterized by progressive muscle rigidity and spasms. While it predominantly affects adults, pediatric cases are exceptionally rare, often leading to delayed diagnosis due to non-specific early clinical manifestations. Case Report: We report the case of an 11-year-old boy with progressive gait abnormalities and rigidity, initially misdiagnosed as an orthopedic disorder. The patient exhibited a forward-leaning posture, absent lumbar lordosis, and significant muscle tightness, leading to a primary surgical intervention. Despite initial improvement, symptom recurrence prompted further evaluation, ultimately raising suspicion of SPS. The absence of pyramidal or extrapyramidal signs complicated early diagnosis, highlighting the challenges in recognizing SPS in pediatric patients. Discussion: SPS diagnosis relies on clinical criteria, serological markers, and electromyography. Autoantibodies against glutamic acid decarboxylase (anti-GAD) are commonly associated, although other markers may be present in atypical forms. Pediatric SPS is often misdiagnosed as dystonia, metabolic myopathy, or an orthope