Practical Neurology Podcast Stiff-person syndrome
Feb 22, 2025
In this discussion, Professor Saiju Jacob, a leading consultant neurologist specializing in neuroimmunology, explores Stiff-Person Syndrome (SPS), a complex autoimmune disorder. He highlights the diagnostic dilemmas faced, particularly its prevalence in women and the role of specific antibody tests. The conversation delves into associated ocular symptoms and the importance of clinical history in accurate diagnosis. Professor Jacob also discusses treatment strategies, emphasizing the need for early intervention and the potential improvements in mental health with effective management.
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SPS Symptoms and Prevalence
- Stiff-person syndrome (SPS) involves axial stiffness, hyperlordotic posture, and exaggerated startle responses.
- SPS isn't limited to humans and can affect other mammals.
SPS Demographics
- SPS is more common in women than men (2:1 ratio) and typically affects people aged 20-50.
- It's rarely diagnosed in children (<5%) and has no known racial predilection.
Misdiagnosis of SPS
- SPS is often misdiagnosed as a functional neurological disorder due to associated neuropsychiatric symptoms (anxiety, phobias).
- The lack of hard physical signs and normal brain/spine scans further complicate diagnosis.