Why It Is Not Always Anxiety: A Tough Diagnosis of Stiff Person Syndrome
Table 2
Treatment options for stiff person syndrome.
Type of treatment
Treatment description
First-line treatment
(i) Benzodiazepines (ii) Diazepam is used both as an anticonvulsant and as a muscle relaxant, with oral baclofen
Other GABAergic drugs
(i) Gabapentin, tiagabine, and levetiracetam have been used for reduction in symptoms
Oral versus intrathecal baclofen
(i) Oral baclofen with diazepam is part of the first-line treatment for agonist activity directed against spasticity (ii) Intrathecal baclofen has been used for severe spasticity and has shown significant improvement
Treatment with intravenous immunoglobulin versus plasmapheresis
(i) IVIG (2 g/kg over two to five days) is used for symptomatic relief when first-line treatment fails and patients have severe disability in carrying out daily activities (ii) Plasmapheresis showed promising results in 56% of patients when first-line therapy failed [7]
Rituximab
(i) Monoclonal antibody that binds to the B-lymphocyte cluster of differentiation surface antigen (ii) Administration: 2 doses are infused with spacing of 7–14 days or as four weekly infusions (iii) Improves gait when benzodiazepines and monthly IVIG treatment have failed