Neurológia pre prax 6/2010

Stiff limb syndrome

Stiff limb syndrom is characterized by muscle stiffness and episodic painful spasms of one or two extremities. Pathophysiological basis of this syndrome is a disturbance of spinal motoneurone inhibition. For a correct diagnosis are of upmost importance – electromyographic investigation with continuous motor units activity. Finding of antibodies against glutamic acid decarboxylase in blood and cerebrospinal fluid is of supportive value. For therapy are used – drugs increasing gabaergic inhibition (diazepam, baclofene), immunosuppression (methylprednisolone i. v., immunoglobulin i. v.) or therapeutic plasma exchange. The authors present a case report of 65-year old woman with a severe form of stiff limb syndrome with asymmetric stiffness of both lower extremities, difficult ambulation, typical findings and a very good response to therapy (methylprednisolone i. v.).

Keywords: stiff limb syndrome, stiff person syndrome, glutamic acid decarboxylase, herpes zoster.