Treatment
Treatment is mostly palliative with muscle relaxants which potentiate GABA action, such as benzodiazepines. These treatments lose their effectiveness as the illness progresses.
In the absence of double-blind, placebo-controlled trials to determine treatment efficacy, some authorities recommend human trials of immunosuppressive therapy, plasmapheresis or intravenous immunoglobulin infusion. A recent study funded by the NINDS demonstrated the effectiveness of intravenous immunoglobulin (IVIg) treatment in reducing stiffness and lowering sensitivity to noise, touch, and stress in people with SPS.
Monoclonal antibody rituximab has produced long-lasting remissions. Clinical trials of this treatment have been completed. NINDS also recently tested plasmapherisis as another treatment option.
One case found symptoms improved unexpectedly from propofol administration.
Physical therapy is another treatment option for people with stiff person syndrome. It may help attenuate spasms in some patients, but physiotherapy should be used cautiously in patients for whom passive movements trigger spasms. Some physical therapy treatment approaches may include therapeutic exercise, functional retraining, and training family members..) Therapeutic exercises for people with stiff man syndrome would likely include a stretching program to help patients gain range of motion by reducing muscle spasms and muscle stiffness. Functional retraining would have a large emphasis on gait training to increase endurance, independence, and the ability to climb stairs. Practicing sitting to standing, in a variety of situations, would aid a person in becoming more independent, especially with activities of daily living. Training the patient’s family would allow the family to help with home stretches and situations where the person is dependent on another person (i.e. wheelchair transfers, getting dressed, ambulating long distance, etc.) Physical therapy may not change the disease course in the long-term, however, it may help optimize current function as well as have some positive short term effects.
Read more about this topic: Stiff Person Syndrome
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