Stiff-person症候群に生じた陳旧性両肩関節後方脱臼の1例

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The stiff-person syndrome is a rare neurological disorder characterized by progressive stiffness of the axial muscles and co-contraction of agonist and antagonist muscles sometimes accompanied by involuntary sudden muscle spasm. We present a case with bilateral posterior dislocation of the shoulder following a seizure by a stiff-person syndrome. A 30-year-old man who had seizures about fifth per day for the past 2 weeks was diagnosed as a stiff-person syndrome associated with a thymoma and a myasthenia gravis. He had pain of the left shoulder and presented himself to us. His left shoulder was dislocated posteriorly associated with a bone defect on the humeral head and glenoid rim was caught in this defect. For controlling the seizures anticonvulsants were administrated and metylprednisolone pulse treatment was done, and then the thymus was removed. During this treatment he felt pain in his right shoulder. His right shoulder was also dislocated posteriorly. After controlling the seizures hemi-arthroplasties were performed on both shoulders gradually. After the operations, pain of both shoulders had improved. Bilateral posterior dislocation is a rare injury known to be associated with seizures. In this case, controlling the seizures was very difficult and so seizures occurred many times in both shoulders in the dislocated position. We thought that, therefore, large bone defects on the humeral heads had occurred.
日本肩関節学会の論文