Walsh & Hoyt: Stiff-Man Syndrome

Stiff-man syndrome is a disorder characterized by progressive symmetric stiffness and spasms affecting the muscles of the trunk, abdomen, and proximal extremities that produces an awkward posture and gait appearance from whence the name of the disorder was derived. The facial and bulbar muscles are usually spared in this condition. Early symptoms include muscle aching and tightness. Later, intermittent intense painful spasms of affected muscles, lasting minutes at a time, are typically precipitated by various stimuli, such as sudden loud noises or passive stretching of an affected limb. Physical findings include an awkward appearing and cautious gait from lumbar hyperlordosis and fear of painful spasms, and tight hard paravertebral and abdominal muscles. Motor, sensory, cranial nerve, cerebellar, and muscle stretch reflex functions are generally otherwise normal apart from hyperreflexia.