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Review
Stiff-person syndrome: insights into a complex autoimmune disorder
  1. José Fidel Baizabal-Carvallo,
  2. Joseph Jankovic
  1. Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Dr José Fidel Baizabal-Carvallo, Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, The Smith Tower, Suite 1801, 6550 Fannin, Houston, TX 77030, USA; baizabaljf{at}hotmail.com

Abstract

Stiff-person syndrome (SPS) is characterised by progressive rigidity and muscle spasms affecting the axial and limb muscles. Since its initial description in 1956, marked progress has been made in the clinical characterisation, understanding of pathogenesis and therapy of this disorder. SPS can be classified according to the clinical presentation into classic SPS and SPS variants: focal or segmental-SPS, jerking-SPS and progressive encephalomyelitis with rigidity and myoclonus. Most patients with SPS have antibodies directed against the glutamic acid decarboxylase, the rate-limiting enzyme for the production of the inhibitory neurotransmitter γ-aminobutyric acid (GABA). Antibodies directed against GABAA receptor-associated protein, and the glycine-α1 receptor can also be observed. Paraneoplastic SPS is commonly associated with antiamphiphysin antibodies and breast cancer. Treatment of SPS with drugs that increase the GABAergic tone combined with immunotherapy can improve the neurological manifestations of these patients. The prognosis, however, is unpredictable and spontaneous remissions are unlikely.

  • MOVEMENT DISORDERS
  • STIFF MAN SYNDROME

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