STIFF-MAN SYNDROME - REPORT OF A CASE

Stiff-man syndrome is a well-described, but rare and often overlooked, neuromuscular syndrome of rigidity, spasm, and gait abnormality that is associated with several endocrinologic and autoimmune disorders. A patient exhibiting many typical features of stiff-man syndrome had int ermittent symptoms for 22 years before the correct diagnosis was made. Similar to many described patients, she was diabetic, hyperthyroid, a nd had elevated islet cell, antithyroid, and glutamic acid decarboxyla se antibody levels. The high frequency of diabetes mellitus among pati ents with stiff-man syndrome is emphasized, as is increasing evidence to suggest that elaboration of anti-glutamic acid decarboxylase and an ti-islet cell antibodies may play a role in the pathophysiologic state of the disorder.