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Stiff Person Syndrome

VERSION: 1.1 CREATED: January 30, 2026 REVISED: January 30, 2026 STATUS: Approved


DIAGNOSIS: Stiff Person Syndrome (SPS)

ICD-10: G25.82 (Stiff-man syndrome)

CPT CODES: 85025 (CBC with differential), 80053 (CMP (BMP + LFTs)), 86235 (Anti-GAD65 antibodies (serum)), 82550 (CK (creatine kinase)), 82947 (Blood glucose), 83036 (HbA1c), 84443 (TSH), 84439 (Free T4), 85652 (ESR), 86140 (CRP), 83735 (Magnesium), 84100 (Phosphorus), 83605 (Lactate), 81003 (Urinalysis), 87040 (Blood cultures (x2 sets)), 82607 (Vitamin B12), 86255 (Paraneoplastic antibody panel (Hu, Yo, Ri, CV2/CRMP5, Ma2)), 86376 (Anti-thyroid peroxidase (anti-TPO)), 86800 (Anti-thyroglobulin antibodies), 86340 (Anti-intrinsic factor antibodies), 86337 (Insulin antibodies), 86341 (Islet cell antibodies (ICA)), 86334 (Serum protein electrophoresis (SPEP)), 82784 (Quantitative immunoglobulins (IgG, IgA, IgM)), 87389 (HIV), 80074 (Hepatitis B surface antigen + core antibody), 86480 (QuantiFERON-TB Gold), 70553 (MRI brain with and without gadolinium), 95907-95913 (EMG/NCS (electromyography/nerve conduction studies)), 74178 (CT chest/abdomen/pelvis with contrast), 93000 (ECG (12-lead)), 71046 (Chest X-ray), 77067 (Mammography (females)), 71260 (CT chest with contrast (if not done above)), 78816 (PET/CT (whole body)), 76856 (Pelvic ultrasound (females)), 76870 (Testicular ultrasound (males, young)), 76830 (Transvaginal ultrasound (females)), 88305 (Skin biopsy (punch) for small fiber neuropathy), 77049 (MRI breast (if mammography inconclusive)), 95711 (Video-EEG monitoring (long-term)), 89050 (Opening pressure), 89051 (Cell count with differential (tubes 1 and 4)), 84157 (Protein), 82945 (Glucose with paired serum glucose), 83916 (Oligoclonal bands (CSF AND paired serum)), 83787 (IgG index), 88104 (CSF cytology), 88184 (CSF flow cytometry)

SYNONYMS: Stiff person syndrome, SPS, stiff-man syndrome, Moersch-Woltman syndrome, stiff-limb syndrome, SLS, progressive encephalomyelitis with rigidity and myoclonus, PERM, stiff trunk syndrome, stiff person spectrum disorder, SPSD, anti-GAD stiffness syndrome, autoimmune rigidity syndrome, GAD antibody-associated stiffness, stiff body syndrome

SCOPE: Diagnostic workup and management of suspected or confirmed Stiff Person Syndrome and its spectrum disorders (classic SPS, stiff-limb syndrome, PERM) across all care settings. Covers initial evaluation, antibody testing (anti-GAD65, anti-amphiphysin, anti-DPPX, anti-glycine receptor), EMG findings, first-line symptomatic therapy (benzodiazepines, baclofen), immunotherapy (IVIg, rituximab, plasmapheresis), and management of acute exacerbations including status spasticus. For isolated cerebellar ataxia with anti-GAD antibodies or autoimmune epilepsy with anti-GAD antibodies, use respective templates. For tetanus or functional neurological disorder evaluation, use respective templates.


DEFINITIONS: - Classic Stiff Person Syndrome: Progressive rigidity and episodic spasms affecting primarily axial and proximal limb muscles with continuous motor unit activity on EMG and positive anti-GAD65 antibodies (typically >2000 IU/mL) - Stiff-Limb Syndrome (SLS): Variant with rigidity and spasms predominantly affecting one or more limbs, often asymmetric; anti-GAD65 may be positive - Progressive Encephalomyelitis with Rigidity and Myoclonus (PERM): Most severe variant with brainstem and spinal cord involvement; rigidity, myoclonus, autonomic dysfunction, encephalopathy; associated with anti-glycine receptor (GlyR) antibodies or anti-DPPX antibodies - Paraneoplastic SPS: SPS associated with anti-amphiphysin antibodies; most commonly breast cancer, lung cancer, or thymoma - Status Spasticus: Severe, prolonged, unrelenting spasms with potential for respiratory compromise, rhabdomyolysis, and autonomic instability; neurological emergency


PRIORITY KEY: STAT = Immediate | URGENT = Within hours | ROUTINE = Standard | EXT = Extended/atypical cases | - = Not applicable to this setting

═══════════════════════════════════════════════════════════ SECTION A: ACTION ITEMS ═══════════════════════════════════════════════════════════

1. LABORATORY WORKUP

1A. Essential/Core Labs

Test Rationale Target Finding ED HOSP OPD ICU
CBC with differential (CPT 85025) Baseline; infection screen; pre-immunotherapy assessment Normal STAT STAT ROUTINE STAT
CMP (BMP + LFTs) (CPT 80053) Metabolic screen; renal/hepatic function; pre-immunotherapy baseline Normal STAT STAT ROUTINE STAT
Anti-GAD65 antibodies (serum) (CPT 86235) Primary diagnostic antibody; present in ~80% of classic SPS; titers >2000 IU/mL highly suggestive of SPS (vs. lower titers in T1DM, cerebellar ataxia) Positive, high titer (>2000 IU/mL) URGENT STAT ROUTINE URGENT
CK (creatine kinase) (CPT 82550) Rhabdomyolysis from severe spasms; elevated during acute exacerbations Normal or elevated during spasms STAT STAT ROUTINE STAT
Blood glucose (CPT 82947) Screen for concurrent type 1 diabetes mellitus (30-60% comorbidity with SPS); pre-treatment baseline Normal or elevated (if T1DM) STAT STAT ROUTINE STAT
HbA1c (CPT 83036) Type 1 diabetes mellitus screening and monitoring (common autoimmune comorbidity) <5.7% (normal); >6.5% suggests DM - ROUTINE ROUTINE -
TSH (CPT 84443) Autoimmune thyroiditis screening (common comorbidity) Normal URGENT ROUTINE ROUTINE URGENT
Free T4 (CPT 84439) Thyroid function if TSH abnormal Normal URGENT ROUTINE ROUTINE URGENT
ESR (CPT 85652) Inflammatory marker; baseline Normal to mildly elevated URGENT ROUTINE ROUTINE URGENT
CRP (CPT 86140) Inflammatory marker; infection screen Normal URGENT ROUTINE ROUTINE URGENT
Magnesium (CPT 83735) Hypomagnesemia can exacerbate spasms; seizure threshold Normal (1.8-2.4 mg/dL) STAT STAT ROUTINE STAT
Calcium (total and ionized) (CPT 82310+82330) Hypocalcemia exacerbates spasms; metabolic screen Normal STAT STAT ROUTINE STAT
Phosphorus (CPT 84100) Metabolic screen Normal STAT STAT ROUTINE STAT
Lactate (CPT 83605) Lactic acidosis from prolonged severe spasms Normal (<2 mmol/L) STAT STAT - STAT
PT/INR, aPTT (CPT 85610+85730) Coagulation status pre-LP Normal STAT STAT - STAT
Urinalysis (CPT 81003) Myoglobinuria screen if rhabdomyolysis suspected; infection screen Negative for myoglobin STAT STAT ROUTINE STAT
Blood cultures (x2 sets) (CPT 87040) Rule out infection (especially tetanus differential; pre-immunosuppression) No growth STAT STAT - STAT
Vitamin B12 (CPT 82607) Myelopathy/neuropathy differential Normal (>300 pg/mL) - ROUTINE ROUTINE -

1B. Extended Workup (Second-line)

Test Rationale Target Finding ED HOSP OPD ICU
Anti-amphiphysin antibodies (serum) (CPT 86235) Paraneoplastic SPS marker; associated with breast cancer, lung cancer, thymoma; present in ~5% of SPS Negative (positive indicates paraneoplastic variant) - URGENT ROUTINE URGENT
Anti-glycine receptor (GlyR) antibodies (serum) (CPT 86235) PERM variant marker; associated with brainstem involvement, myoclonus, autonomic dysfunction Negative (positive suggests PERM variant) - URGENT ROUTINE URGENT
Anti-DPPX antibodies (serum) (CPT 86235) PERM variant with hyperexcitability, GI dysmotility, cognitive changes Negative (positive suggests PERM) - URGENT ROUTINE URGENT
Anti-GABA-A receptor antibodies (CPT 86235) Associated with SPS spectrum; seizures and encephalopathy Negative - ROUTINE ROUTINE -
Anti-GABA-B receptor antibodies (CPT 86235) Associated with SPS spectrum; seizures; paraneoplastic Negative - ROUTINE ROUTINE -
Paraneoplastic antibody panel (Hu, Yo, Ri, CV2/CRMP5, Ma2) (CPT 86255) Comprehensive paraneoplastic screen; amphiphysin-positive SPS is paraneoplastic Negative - URGENT ROUTINE URGENT
Anti-thyroid peroxidase (anti-TPO) (CPT 86376) Autoimmune thyroiditis comorbidity screen Negative - ROUTINE ROUTINE -
Anti-thyroglobulin antibodies (CPT 86800) Autoimmune thyroiditis comorbidity screen Negative - ROUTINE ROUTINE -
Anti-parietal cell antibodies (CPT 86255) Pernicious anemia comorbidity screen (autoimmune gastritis) Negative - ROUTINE ROUTINE -
Anti-intrinsic factor antibodies (CPT 86340) Pernicious anemia comorbidity screen Negative - ROUTINE ROUTINE -
Insulin antibodies (CPT 86337) Type 1 diabetes autoimmune panel Negative - ROUTINE ROUTINE -
Islet cell antibodies (ICA) (CPT 86341) Type 1 diabetes autoimmune panel Negative - ROUTINE ROUTINE -
ANA (CPT 86235) Autoimmune comorbidity screen (lupus, Sjogren) Negative or low titer - ROUTINE ROUTINE -
Serum protein electrophoresis (SPEP) (CPT 86334) Monoclonal gammopathy screen; lymphoma differential Normal pattern - ROUTINE ROUTINE -
Quantitative immunoglobulins (IgG, IgA, IgM) (CPT 82784) Baseline before IVIg; hypogammaglobulinemia screen before rituximab Normal - ROUTINE ROUTINE -
HIV (CPT 87389) Immunocompromised screen Negative - ROUTINE ROUTINE -
Hepatitis B surface antigen + core antibody (CPT 80074) Reactivation risk before rituximab or immunosuppression Negative - ROUTINE ROUTINE -
Hepatitis C antibody (CPT 80074) Screen before immunosuppression Negative - ROUTINE ROUTINE -
QuantiFERON-TB Gold (CPT 86480) TB exclusion before immunosuppression Negative - ROUTINE ROUTINE -

1C. Rare/Specialized (Refractory or Atypical)

Test Rationale Target Finding ED HOSP OPD ICU
Anti-GAD65 antibodies (paired CSF and serum with index) (CPT 86235) Intrathecal anti-GAD production; CSF anti-GAD supports diagnosis; serum may be negative in rare cases with positive CSF CSF anti-GAD positive; intrathecal synthesis - EXT EXT -
Anti-RIG1 (CASPR2) antibodies (CPT 86235) Neuromyotonia/Morvan syndrome differential; overlaps with SPS spectrum Negative - EXT EXT -
Anti-LGI1 antibodies (CPT 86235) Autoimmune encephalitis differential with seizures and movement disorder Negative - EXT EXT -
Genetic testing for hereditary hyperekplexia (GLRA1, GLRB, SLC6A5) Hereditary hyperekplexia differential in early-onset cases Negative - - EXT -
Stiff person syndrome-specific autoantibody panel (comprehensive) Commercial panels including GAD65, amphiphysin, DPPX, GlyR, GABA-A, GABA-B Identifies specific antibody profile - EXT EXT -
Serum free light chains (kappa/lambda) Monoclonal gammopathy and lymphoproliferative disorder screen Normal ratio - EXT EXT -
Catecholamines (plasma) and metanephrines Pheochromocytoma if paroxysmal hypertension with spasms (rare differential) Normal - EXT EXT -

2. DIAGNOSTIC IMAGING & STUDIES

2A. Essential/First-line

Study Timing Target Finding Contraindications ED HOSP OPD ICU
MRI brain with and without gadolinium (CPT 70553) Within 24-48h Typically NORMAL in classic SPS (important negative finding); may show cerebellar atrophy if anti-GAD cerebellar involvement; rule out structural lesions, MS, myelopathy GFR <30; gadolinium allergy; pacemaker URGENT URGENT ROUTINE URGENT
MRI spine (cervical and thoracic) with and without gadolinium (CPT 72156+72157) Within 24-48h Typically NORMAL in classic SPS; rule out myelopathy (compressive, inflammatory, vascular); may show cord signal in PERM variant GFR <30; gadolinium allergy URGENT URGENT ROUTINE URGENT
EMG/NCS (electromyography/nerve conduction studies) (CPT 95907-95913) Within 1-7 days Continuous motor unit activity (CMUA) at rest in agonist and antagonist muscles simultaneously; no voluntary suppression; involuntary co-contraction pattern; motor units normal morphology Anticoagulation (relative for needle EMG) - URGENT ROUTINE -
CT chest/abdomen/pelvis with contrast (CPT 74178) Within 1-2 weeks Malignancy screen (breast, lung, thymoma, lymphoma); especially if anti-amphiphysin positive Contrast allergy; renal insufficiency - URGENT ROUTINE URGENT
ECG (12-lead) (CPT 93000) Immediate Baseline rhythm; QTc assessment; autonomic dysfunction None STAT STAT ROUTINE STAT
Chest X-ray (CPT 71046) Immediate Pulmonary pathology screen; malignancy screen Pregnancy (relative) STAT STAT ROUTINE STAT

2B. Extended

Study Timing Target Finding Contraindications ED HOSP OPD ICU
Mammography (females) (CPT 77067) Within 2-4 weeks Breast cancer screening (paraneoplastic SPS, especially anti-amphiphysin) Breast implants (relative) - ROUTINE ROUTINE -
CT chest with contrast (if not done above) (CPT 71260) Within 1-2 weeks Thymoma; lung cancer; mediastinal lymphadenopathy Contrast allergy; renal insufficiency - ROUTINE ROUTINE -
PET/CT (whole body) (CPT 78816) Within 2-4 weeks Occult malignancy (if paraneoplastic SPS suspected or anti-amphiphysin positive); breast, lung, thymoma, lymphoma Uncontrolled diabetes; pregnancy - ROUTINE ROUTINE -
Pelvic ultrasound (females) (CPT 76856) Within 2-4 weeks Ovarian cancer screen (paraneoplastic) None significant - ROUTINE ROUTINE -
Testicular ultrasound (males, young) (CPT 76870) Within 2-4 weeks Testicular cancer screen if paraneoplastic suspected None significant - ROUTINE ROUTINE -
Transvaginal ultrasound (females) (CPT 76830) Within 2-4 weeks Ovarian pathology; paraneoplastic screen Patient refusal - ROUTINE ROUTINE -
EEG (routine or continuous) (CPT 95816 or 95711) Within 1-7 days Rule out epileptic origin of spasms; PERM variant may show encephalopathic changes; differentiate from epileptic myoclonus None significant URGENT URGENT ROUTINE URGENT
Pulmonary function tests (PFTs) with inspiratory/expiratory pressures (CPT 94010+94060) Within 1-2 weeks Respiratory muscle function; restrictive pattern from chest wall rigidity; assess ventilatory capacity Unable to cooperate - ROUTINE ROUTINE URGENT
Skin biopsy (punch) for small fiber neuropathy (CPT 88305) Within 2-4 weeks Intraepidermal nerve fiber density; SPS can coexist with small fiber neuropathy Coagulopathy; skin infection at site - - ROUTINE -

2C. Rare/Specialized

Study Timing Target Finding Contraindications ED HOSP OPD ICU
FDG-PET brain If atypical presentation Cerebellar or brainstem hypermetabolism (PERM); cortical dysfunction Uncontrolled diabetes - EXT EXT -
MRI breast (if mammography inconclusive) (CPT 77049) If paraneoplastic suspected Occult breast cancer Claustrophobia; breast implants (relative) - EXT EXT -
Video-EEG monitoring (long-term) (CPT 95711) If diagnosis uncertain Distinguish epileptic vs. non-epileptic spasms; characterize movement phenomenology None significant - EXT EXT -
Somatosensory evoked potentials (SSEPs) (CPT 95925+95926) If PERM suspected Central sensory pathway assessment; spinal cord involvement None significant - EXT EXT -

LUMBAR PUNCTURE

Indication: Supports diagnosis of SPS via CSF anti-GAD65 antibodies and intrathecal synthesis; rules out infectious/inflammatory mimics; essential when serum antibodies equivocal or negative but clinical suspicion remains high

Timing: URGENT in ED/hospital setting if diagnosis uncertain; ROUTINE for outpatient diagnostic workup. Perform after CT/MRI to rule out mass lesion

Volume Required: 10-15 mL (standard diagnostic volume; sufficient for antibody studies and basic CSF)

Study Rationale Target Finding ED HOSP OPD ICU
Opening pressure (CPT 89050) Assess for elevated ICP; typically normal in SPS 10-20 cm H2O (normal) URGENT ROUTINE ROUTINE -
Cell count with differential (tubes 1 and 4) (CPT 89051) Rule out infection and inflammation; usually normal or mild pleocytosis in SPS WBC <5 (usually normal); RBC 0 STAT STAT ROUTINE STAT
Protein (CPT 84157) May be mildly elevated; rule out infectious meningitis Normal to mildly elevated (15-60 mg/dL) STAT STAT ROUTINE STAT
Glucose with paired serum glucose (CPT 82945) Rule out infectious meningitis; typically normal in SPS Normal (>60% of serum) STAT STAT ROUTINE STAT
CSF anti-GAD65 antibodies (CPT 86235) Intrathecal anti-GAD synthesis; may be positive even when serum is negative; calculate CSF/serum ratio to confirm intrathecal production Positive (supports diagnosis); calculate index URGENT URGENT ROUTINE URGENT
Oligoclonal bands (CSF AND paired serum) (CPT 83916) Intrathecal IgG synthesis; may show CSF-specific bands in SPS; helps distinguish from MS May show CSF-specific bands URGENT ROUTINE ROUTINE -
IgG index (CPT 83787) Intrathecal antibody synthesis May be elevated URGENT ROUTINE ROUTINE -
Gram stain and bacterial culture (CPT 87205+87070) Rule out bacterial meningitis (tetanus differential) No organisms STAT STAT ROUTINE STAT
CSF cytology (CPT 88104) Malignancy exclusion if paraneoplastic suspected Negative for malignant cells - ROUTINE ROUTINE -
CSF flow cytometry (CPT 88184) CNS lymphoma exclusion if atypical presentation Normal - ROUTINE ROUTINE -

Special Handling: CSF anti-GAD65 requires paired serum sample drawn simultaneously for index calculation. Store extra CSF (frozen at -20C) for future testing. Process CSF antibodies promptly.

Contraindications: Elevated ICP without imaging (get CT/MRI first); coagulopathy (INR >1.5, platelets <50K); skin infection at LP site; severe spasms preventing safe positioning (may require sedation)


3. TREATMENT

3A. Acute/Emergent

Treatment Route Indication Dosing Contraindications Monitoring ED HOSP OPD ICU
Diazepam IV Acute severe spasms; status spasticus; first-line benzodiazepine for SPS 5-10 mg :: IV :: PRN q5-10 min :: 5-10 mg IV push over 2-5 minutes; may repeat q5-10 min PRN; max 30 mg in first hour; then transition to scheduled dosing; typical maintenance 10-30 mg PO TID-QID Respiratory depression without ventilator support; acute narrow-angle glaucoma; severe hepatic insufficiency; myasthenia gravis Respiratory rate; SpO2; sedation level; BP; airway patency; have flumazenil available STAT STAT - STAT
Lorazepam IV Acute spasms; alternative to diazepam if IV diazepam unavailable; status spasticus 2-4 mg :: IV :: PRN q5-10 min :: 2-4 mg IV push over 2 minutes; may repeat q5-10 min; max 8 mg in first hour; less lipophilic than diazepam (shorter CNS duration) Respiratory depression without ventilator support; acute narrow-angle glaucoma; severe hepatic insufficiency Respiratory rate; SpO2; sedation level; BP; airway patency STAT STAT - STAT
Midazolam IV Status spasticus requiring continuous infusion; ICU setting 0.05 mg/kg/hr :: IV :: continuous infusion :: 0.5-1 mg IV bolus, then 0.05-0.2 mg/kg/hr continuous infusion; titrate to spasm control; taper gradually over days once spasms controlled Respiratory depression (requires mechanical ventilation for continuous infusion); acute narrow-angle glaucoma Continuous SpO2; respiratory rate; BP; sedation level (RASS); ventilator settings - - - STAT
Propofol IV Refractory status spasticus not responding to benzodiazepines; ICU with mechanical ventilation 20 mcg/kg/min :: IV :: continuous infusion :: 0.5-1 mg/kg IV bolus, then 20-50 mcg/kg/min infusion; titrate to spasm suppression; max 80 mcg/kg/min; avoid >48 hours at high doses Propofol allergy (egg/soy); propofol infusion syndrome risk >48h; hemodynamic instability Triglycerides q24h; CK; metabolic panel; lactate; propofol infusion syndrome (fever, rhabdo, metabolic acidosis, cardiac failure); hemodynamics - - - STAT
IV crystalloid (normal saline or lactated Ringer) IV Rhabdomyolysis prevention and treatment during severe spasms 250 mL/hr :: IV :: continuous :: 1-2 L bolus then 150-250 mL/hr; target urine output >200 mL/hr if CK >5000; add sodium bicarbonate 150 mEq/L NS if myoglobinuria Heart failure; volume overload I/O; CK q6h; BMP q6-12h; urine myoglobin; urine output STAT STAT - STAT
Dantrolene IV Refractory spasms with hyperthermia or malignant hyperthermia-like presentation during severe SPS crisis 1-2.5 mg/kg :: IV :: PRN q5-10 min :: 1-2.5 mg/kg IV push; may repeat q5-10 min; max 10 mg/kg; transition to PO 25-100 mg QID when stabilized Hepatic disease; active hepatitis LFTs; hepatotoxicity (BLACK BOX); CK; temperature - URGENT - STAT

Note: Benzodiazepines are the cornerstone of acute SPS management. Diazepam is preferred over lorazepam for SPS because of its longer duration, active metabolite (desmethyldiazepam), and greater efficacy for muscle relaxation. SPS patients often require much higher benzodiazepine doses than typical use and develop tolerance more slowly than expected. Status spasticus is a neurological emergency requiring ICU admission, aggressive benzodiazepine dosing, and consideration of propofol/midazolam infusion with mechanical ventilation.

3B. Symptomatic Treatments

Treatment Route Indication Dosing Contraindications Monitoring ED HOSP OPD ICU
Diazepam PO First-line symptomatic therapy for rigidity and spasms in SPS; GABAergic mechanism addresses pathophysiology 5 mg :: PO :: TID :: Start 5 mg PO TID; titrate by 5 mg/dose every 3-5 days as tolerated; typical effective dose 20-60 mg/day in divided doses; some patients require up to 100+ mg/day; max limited by sedation Respiratory depression; acute narrow-angle glaucoma; severe hepatic insufficiency; myasthenia gravis; severe OSA without CPAP Sedation; respiratory status; falls; cognitive function; tolerance; dependence (do NOT abruptly discontinue) URGENT URGENT ROUTINE URGENT
Baclofen PO Adjunctive to benzodiazepines for rigidity and spasms; GABA-B agonist 5 mg :: PO :: TID :: Start 5 mg PO TID; increase by 5 mg/dose every 3-5 days; target 40-80 mg/day in divided doses; max 80 mg/day (higher doses off-label with close monitoring) Renal impairment (reduce dose); abrupt withdrawal causes seizures and hallucinations Sedation; dizziness; weakness; renal function; do NOT discontinue abruptly (withdrawal seizures, hallucinations, autonomic instability) URGENT URGENT ROUTINE URGENT
Gabapentin PO Adjunctive therapy for rigidity, spasms, and neuropathic pain; anticonvulsant with GABA-modulating properties 300 mg :: PO :: qHS :: Start 300 mg qHS; titrate by 300 mg q1-3d; target 900-1800 mg TID; max 3600 mg/day Renal impairment (adjust dose per CrCl) Sedation; dizziness; peripheral edema; renal function - ROUTINE ROUTINE -
Pregabalin PO Adjunctive therapy for rigidity, spasms, and neuropathic pain; alternative to gabapentin 75 mg :: PO :: BID :: Start 75 mg BID; may increase q1wk; target 150-300 mg BID; max 600 mg/day Renal impairment (adjust dose); Class V controlled substance Sedation; weight gain; peripheral edema; dizziness; renal function - ROUTINE ROUTINE -
Tizanidine PO Adjunctive therapy for rigidity and spasms; alpha-2 adrenergic agonist muscle relaxant 2 mg :: PO :: TID :: Start 2 mg PO TID; increase by 2-4 mg q3-7d; max 36 mg/day divided TID; take consistently with or without food Concurrent fluvoxamine or ciprofloxacin (CYP1A2 inhibitors); hepatic impairment LFTs at baseline, 1, 3, 6 months, then periodically; BP (hypotension); sedation; dry mouth - ROUTINE ROUTINE -
Clonazepam PO Adjunctive benzodiazepine for myoclonus (especially PERM variant); nocturnal spasms 0.5 mg :: PO :: BID :: Start 0.5 mg PO BID; increase by 0.5 mg q3-5d; max 6 mg/day; useful for myoclonus in PERM variant Respiratory depression; severe hepatic disease; acute narrow-angle glaucoma Sedation; ataxia; cognitive impairment; respiratory status; do NOT discontinue abruptly - ROUTINE ROUTINE -
Levetiracetam PO Myoclonus treatment (especially PERM variant); anti-seizure prophylaxis if cortical involvement 500 mg :: PO :: BID :: Start 500 mg PO BID; increase by 500 mg/day q1-2wk; max 3000 mg/day Renal impairment (adjust dose per CrCl) Behavioral changes (rage, irritability); suicidality; renal function URGENT URGENT ROUTINE URGENT
Duloxetine PO Comorbid neuropathic pain; depression and anxiety (common in SPS) 30 mg :: PO :: daily :: Start 30 mg PO daily x 1 week; increase to 60 mg daily; max 120 mg/day Severe hepatic impairment; concurrent MAOIs; uncontrolled narrow-angle glaucoma BP; hepatic function; serotonin syndrome risk; suicidality monitoring - ROUTINE ROUTINE -
Sertraline PO Anxiety and depression comorbidity management; high prevalence in SPS patients 50 mg :: PO :: daily :: Start 50 mg PO daily; increase by 25-50 mg q1-2wk; max 200 mg/day Concurrent MAOIs; concurrent pimozide Suicidality monitoring; serotonin syndrome risk; hyponatremia (SIADH) in elderly - ROUTINE ROUTINE -

Note: Diazepam is the cornerstone of symptomatic SPS management and should be tried FIRST. SPS patients often tolerate very high benzodiazepine doses (60-100+ mg/day of diazepam) without excessive sedation due to the underlying GABAergic deficit. Abrupt benzodiazepine withdrawal in SPS can trigger life-threatening status spasticus. Baclofen is the most commonly used adjunct. Gabapentin/pregabalin provide additional benefit, especially for pain.

3C. Second-line/Refractory

Treatment Route Indication Dosing Contraindications Monitoring ED HOSP OPD ICU
IVIg (intravenous immunoglobulin) IV First-line immunotherapy for SPS; Class I evidence (Dalakas 2001 NEJM RCT); reduces stiffness and improves function 0.4 g/kg/day :: IV :: daily x 5 days :: 0.4 g/kg/day IV for 5 days (total 2 g/kg); infuse initial rate 0.5 mL/kg/hr, increase q30min by 0.5 mL/kg/hr to max 4 mL/kg/hr; premedicate with acetaminophen and diphenhydramine; repeat every 4-6 weeks for maintenance IgA deficiency (anaphylaxis risk -- check IgA level); renal insufficiency (use sucrose-free); hypercoagulable states (thrombosis risk) Renal function (BUN/Cr before each cycle); CBC; vital signs during infusion; headache (aseptic meningitis); DVT/PE risk; hemolysis (DAT, LDH, haptoglobin); IgA level before first infusion - URGENT ROUTINE URGENT
Plasmapheresis (PLEX) IV Acute severe SPS or status spasticus not responding to benzodiazepines and IVIg; removes pathogenic antibodies 1-1.5 plasma volumes :: IV :: q48h x 5 exchanges :: 5 exchanges over 10-14 days (every other day); 1-1.5 plasma volume exchanges per session; albumin replacement (NOT FFP unless coagulopathy); central venous catheter required Active sepsis; hemodynamic instability; heparin allergy (if used); unable to establish vascular access BP and vitals during sessions; calcium (citrate-induced hypocalcemia); fibrinogen; coagulation studies; electrolytes; CBC; line infections - URGENT - STAT
Intrathecal baclofen (ITB pump) IT Refractory rigidity and spasms not controlled by maximal oral medications; severe functional impairment 50-100 mcg :: IT :: trial dose :: Trial: 50-100 mcg intrathecal bolus; if positive response, implant programmable pump; typical maintenance 100-800 mcg/day continuous infusion; titrate over weeks Active infection; coagulopathy; CSF obstruction; patient unable to return for pump refills Pump function and refill schedule; withdrawal symptoms if pump malfunction (medical emergency -- similar to status spasticus); CSF leak; infection; catheter complications - EXT ROUTINE -
Botulinum toxin A (onabotulinumtoxinA) IM Focal refractory rigidity and spasms; specific muscle group targeting 50-200 units :: IM :: q12 weeks :: Dose varies by muscle group; typical 50-200 units per large muscle (e.g., paraspinal); EMG/ultrasound-guided injection; repeat q12 weeks; onset 3-7 days, peak 2-4 weeks Systemic neuromuscular disease (relative); infection at injection site; known antibodies to botulinum toxin Weakness at injection site; dysphagia (if cervical muscles); distant spread effects; antibody development with repeated use - ROUTINE ROUTINE -

Note: IVIg has the strongest evidence for SPS treatment (Class I, Dalakas 2001). Response is typically seen within 1-4 weeks and most patients require ongoing maintenance infusions every 4-6 weeks. PLEX is used for acute flares or status spasticus as a bridging therapy. Intrathecal baclofen should be considered when oral medications are insufficient or cause intolerable side effects.

3D. Disease-Modifying / Immunotherapy (Long-term)

Treatment Route Indication Dosing Pre-Treatment Requirements Contraindications Monitoring ED HOSP OPD ICU
Rituximab IV Second-line immunotherapy for SPS; B-cell depletion reduces anti-GAD production; used when IVIg insufficient or for IVIg-sparing 1000 mg :: IV :: q2wk x 2 doses :: 1000 mg IV x 2 doses (day 0 and day 14); repeat based on CD19/CD20 repopulation or clinical relapse (typically q6 months); premedicate with methylprednisolone 100 mg IV, acetaminophen 650 mg, diphenhydramine 50 mg Hepatitis B serology; CBC, CMP; quantitative immunoglobulins (IgG, IgA, IgM); JCV antibody (PML risk); TB screening (QuantiFERON); pregnancy test; vaccination update (before initiating) Active hepatitis B; severe active infection; live vaccines within 4 weeks; severe hypogammaglobulinemia (IgG <300) Hepatitis B surveillance; CBC q2-4 weeks initially; immunoglobulin levels q3-6 months; CD19/CD20 B-cell counts q3 months; infusion reactions (slow rate if reaction); PML surveillance; infection monitoring - URGENT ROUTINE URGENT
Mycophenolate mofetil PO Steroid-sparing immunosuppression; adjunctive to IVIg or rituximab 500 mg :: PO :: BID :: Start 500 mg PO BID; increase by 500 mg every 2 weeks; target 1000-1500 mg BID (2000-3000 mg/day total); onset of effect 2-3 months CBC, CMP, LFTs; pregnancy test; hepatitis B/C serology; TB screen Pregnancy (Category D -- teratogenic); active infection; concurrent live vaccines CBC q2 weeks x 3 months then monthly; LFTs; GI symptoms (diarrhea, nausea); infection surveillance; pregnancy prevention (two forms of contraception) - ROUTINE ROUTINE -
Azathioprine PO Steroid-sparing agent; adjunctive immunotherapy for SPS 50 mg :: PO :: daily :: Start 50 mg PO daily; increase by 50 mg every 2 weeks; target 2-3 mg/kg/day; onset of action 3-6 months TPMT genotype/activity level; CBC, CMP, LFTs; hepatitis B/C; TB screen TPMT deficiency (myelosuppression risk); concurrent allopurinol (reduce dose 75%); pregnancy (relative) TPMT genotype before starting; CBC q2 weeks x 2 months then monthly; LFTs monthly; amylase if abdominal pain (pancreatitis) - ROUTINE ROUTINE -
Prednisone PO Adjunctive immunosuppression; short-term during acute flares; bridge while waiting for IVIg/rituximab effect; less effective as monotherapy for SPS 0.5-1 mg/kg/day :: PO :: daily :: 0.5-1 mg/kg/day (max 60 mg); taper by 10 mg every 2 weeks to 20 mg, then by 5 mg every 2-4 weeks; attempt to discontinue or reach lowest effective dose; avoid prolonged use (less effective for SPS than for other autoimmune conditions) Active infection; uncontrolled diabetes; avascular necrosis; psychosis from steroids; PUD Glucose; BP; weight; mood; bone density (DEXA if >3 months); ophthalmology (cataracts, glaucoma) - ROUTINE ROUTINE -
Cyclophosphamide IV Severe refractory SPS failing IVIg, rituximab, and other agents; last resort 750 mg/m2 :: IV :: monthly x 6 cycles :: 750 mg/m2 IV monthly for 6 cycles; pre-hydrate with 1L NS; administer with MESNA for uroprotection; adjust for renal function CBC, CMP, UA before each cycle; pregnancy test; fertility counseling; hepatitis B/C; TB screen Pregnancy (Category D); active infection; bone marrow failure; bladder outlet obstruction CBC weekly x 4 weeks after each cycle (nadir day 10-14); UA (hemorrhagic cystitis); BMP; LFTs; fertility preservation discussion; malignancy risk - URGENT ROUTINE URGENT

Note: Corticosteroids are generally LESS effective in SPS compared to other autoimmune neurological conditions. IVIg is the preferred first-line immunotherapy (Class I evidence). Rituximab is increasingly used as second-line or IVIg-sparing therapy, though evidence is Class III-IV. Immunotherapy aims to reduce antibody-mediated GABAergic inhibition impairment. Most patients require combination of symptomatic therapy (benzodiazepines) PLUS immunotherapy for optimal outcomes. Treatment is typically lifelong as relapse is common on discontinuation.


4. OTHER RECOMMENDATIONS

4A. Referrals & Consults

Recommendation ED HOSP OPD ICU
Neurology (neuroimmunology specialist) for diagnosis confirmation, antibody interpretation, immunotherapy guidance, and long-term management plan STAT STAT ROUTINE STAT
Neuromuscular medicine for EMG/NCS to document continuous motor unit activity and confirm electrophysiologic diagnosis - URGENT ROUTINE -
Rheumatology or endocrinology for autoimmune comorbidity management (T1DM, thyroiditis, pernicious anemia, vitiligo) - ROUTINE ROUTINE -
Oncology for paraneoplastic evaluation and tumor management if anti-amphiphysin positive or malignancy identified - URGENT ROUTINE URGENT
Physical therapy for gait training, flexibility, balance assessment, and fall prevention given rigidity and impaired mobility - ROUTINE ROUTINE ROUTINE
Occupational therapy for ADL adaptation, assistive device evaluation, and energy conservation given functional limitations from rigidity - ROUTINE ROUTINE ROUTINE
Pain management for refractory pain and spasms not responding to first-line agents - ROUTINE ROUTINE -
Psychiatry for anxiety and depression management; high prevalence of task-specific phobias and agoraphobia in SPS due to fear of triggering spasms - ROUTINE ROUTINE -
Pulmonology for respiratory function assessment if chest wall rigidity compromises ventilation - URGENT ROUTINE URGENT
Anesthesiology consult for intrathecal baclofen pump trial and surgical planning if refractory to oral medications - - ROUTINE -
Social work for disability resources, home health services, and insurance navigation for IVIg coverage - ROUTINE ROUTINE -
Ophthalmology for visual assessment if anti-GAD associated optic neuropathy or cerebellar involvement - ROUTINE ROUTINE -
Infusion center coordination for IVIg, rituximab, or cyclophosphamide outpatient infusions - ROUTINE ROUTINE -
Neurosurgery consultation for intrathecal baclofen pump implantation if ITB trial successful - - ROUTINE -

4B. Patient Instructions

Recommendation ED HOSP OPD ICU
Return to ED immediately for uncontrolled spasms, difficulty breathing, falls with injury, or inability to walk (may indicate status spasticus requiring ICU care) Y Y Y -
SPS is a chronic, treatable autoimmune condition -- improvement is expected with appropriate therapy but may take weeks to months; this is a lifelong condition requiring ongoing treatment Y Y Y -
Do NOT stop benzodiazepines abruptly as this may trigger life-threatening status spasticus (severe unrelenting spasms, respiratory failure); always taper under physician supervision Y Y Y -
Avoid known triggers for spasms: sudden loud noises, unexpected touch, emotional stress, cold temperatures, sudden movements, and crowded environments - Y Y -
Report signs of infection immediately (fever >100.4F, cough, dysuria, rash) as immunosuppressive therapy (IVIg, rituximab) increases infection risk - Y Y -
Do not drive until cleared by neurology due to risk of sudden spasms, impaired mobility, and medication sedation effects Y Y Y -
Keep a spasm diary tracking frequency, severity, triggers, and medication effects to guide treatment optimization - Y Y -
Monitor blood sugars regularly if diabetic or if starting corticosteroids (steroids significantly elevate blood glucose; SPS has high T1DM comorbidity) Y Y Y -
Avoid live vaccines while on immunosuppressive therapy including rituximab and mycophenolate; inform all physicians and pharmacists of immunosuppression status - Y Y -
Carry medical alert identification (bracelet/card) indicating Stiff Person Syndrome, current medications (especially benzodiazepines and immunotherapy), and emergency contact information - Y Y -
Attend all follow-up appointments -- SPS requires regular monitoring with labs, clinical assessments, and periodic antibody levels - Y Y -
In case of surgery or medical procedure, inform anesthesiologist about SPS (risk of exacerbated spasms with certain anesthetic agents; benzodiazepines must NOT be withheld perioperatively) - Y Y -
Avoid alcohol as it potentiates benzodiazepine sedation and increases fall risk - Y Y -

4C. Lifestyle & Prevention

Recommendation ED HOSP OPD ICU
Gentle stretching and range-of-motion exercises daily to maintain flexibility and reduce rigidity; avoid high-impact or startling exercises - Y Y -
Warm-water pool therapy (aquatic physical therapy) as tolerated -- warmth and buoyancy reduce spasm frequency and severity - - Y -
Fall prevention measures at home (remove loose rugs, adequate lighting, grab bars in bathroom, non-slip mats) given rigidity and balance impairment - Y Y -
Stress management techniques (meditation, deep breathing, progressive muscle relaxation, cognitive behavioral therapy) as emotional stress is a common spasm trigger - Y Y -
Adequate sleep (7-8 hours nightly); maintain regular sleep schedule; benzodiazepine dosing may need evening adjustment for nocturnal spasms - Y Y -
Low-impact exercise program as tolerated (walking, stationary cycling, yoga with modifications) to prevent deconditioning from immobility - Y Y -
Temperature regulation: avoid extreme cold which can trigger spasms; dress in layers; maintain comfortable ambient temperature - Y Y -
Assistive device evaluation (cane, walker, wheelchair) based on functional status and fall risk to maintain independence and safety - Y Y -
Vaccinations should be up to date before initiating immunosuppressive therapy (pneumococcal, influenza, hepatitis B, COVID-19); avoid live vaccines on immunosuppression - Y Y -
Bone protection with calcium and vitamin D if on chronic corticosteroids; DEXA scan if steroid use >3 months - Y Y -
Smoking cessation to improve respiratory function and reduce infection risk during immunosuppression Y Y Y -
Support group referral: Stiff Person Syndrome Research Foundation (stiffperson.org) for peer support and disease education - - Y -

═══════════════════════════════════════════════════════════ SECTION B: REFERENCE (Expand as Needed) ═══════════════════════════════════════════════════════════

5. DIFFERENTIAL DIAGNOSIS

Alternative Diagnosis Key Distinguishing Features Tests to Differentiate
Multiple sclerosis (MS) Relapsing-remitting course; white matter lesions on MRI; oligoclonal bands; optic neuritis; Lhermitte sign; spasticity from upper motor neuron damage (not rigidity) MRI brain/spine (periventricular lesions, Dawson fingers); CSF oligoclonal bands; anti-GAD negative; no continuous motor unit activity on EMG
Myelopathy (compressive or inflammatory) Upper motor neuron signs (hyperreflexia, Babinski, spasticity); sensory level; bowel/bladder dysfunction; structural cause on imaging MRI spine (cord compression or signal change); normal EMG (no CMUA); anti-GAD negative
Tetanus Acute onset; history of wound/infection; trismus (lockjaw); opisthotonus; risus sardonicus; no antibody elevation; self-limited with treatment Wound culture; tetanus toxin assay; history of incomplete vaccination; anti-GAD negative; EMG may show CMUA but resolves with treatment
Neuromyotonia (Isaacs syndrome) Peripheral nerve hyperexcitability; myokymia; fasciculations; sweating; muscle cramps; anti-CASPR2/anti-LGI1 antibodies; no axial rigidity predominance EMG (neuromyotonic discharges, myokymic discharges); anti-CASPR2/LGI1 antibodies; anti-GAD negative; distinct EMG pattern from SPS
Functional neurological disorder (FND) Inconsistent symptoms; entrainment; distractibility; positive Hoover sign; no continuous motor unit activity at rest; normal antibodies EMG normal at rest; anti-GAD negative; positive functional neurological examination findings (Hoover, tremor entrainment); psychiatric comorbidity common
Primary lateral sclerosis (PLS) Progressive spasticity; upper motor neuron signs; no sensory involvement; slow progression over years; no antibody positivity; no episodic spasms EMG (no CMUA; upper motor neuron pattern); anti-GAD negative; MRI (motor cortex atrophy); slow progression
Hereditary spastic paraplegia (HSP) Family history; progressive lower extremity spasticity; insidious onset; genetic mutations identified Genetic testing (SPG genes); anti-GAD negative; EMG normal at rest; family history
Ankylosing spondylitis Axial rigidity from joint/ligament pathology; inflammatory back pain; sacroiliac involvement; HLA-B27 positive X-ray/MRI of sacroiliac joints; HLA-B27; ESR/CRP elevated; anti-GAD negative; EMG normal
Parkinson disease Rigidity (lead-pipe, cogwheel); bradykinesia; resting tremor; asymmetric onset; dopamine-responsive DAT scan; clinical features (bradykinesia required); anti-GAD negative; EMG shows no CMUA; L-dopa trial
Dystonia (generalized or segmental) Sustained or intermittent muscle contractions causing abnormal postures; task-specific; patterned movements; may have sensory tricks EMG (patterned co-contraction during movement, not continuous at rest); DYT gene testing; anti-GAD negative; different movement pattern
Myotonia (myotonic dystrophy, channelopathies) Difficulty relaxing muscles; grip myotonia; percussion myotonia; genetic basis; no startle-induced spasms EMG (myotonic discharges -- dive-bomber sound); genetic testing (DMPK, CNBP, SCN4A, CLCN1); anti-GAD negative
Hyperekplexia (startle disease) Exaggerated startle response from birth/infancy; neonatal stiffness; genetic (GLRA1, GLRB); no progressive rigidity; responds to clonazepam Genetic testing (glycine receptor mutations); onset in infancy; anti-GAD negative; EMG (startle reflex but no CMUA at rest)
Neuroleptic malignant syndrome (NMS) Acute onset; recent neuroleptic use; hyperthermia; autonomic instability; CK markedly elevated; encephalopathy Medication history (neuroleptic exposure); CK markedly elevated; hyperthermia; resolves with drug discontinuation
Serotonin syndrome Acute onset; serotonergic drug exposure; clonus (especially lower extremity); hyperreflexia; hyperthermia; agitation Medication history (serotonergic drugs); clonus (distinct from rigidity); resolves with drug discontinuation and cyproheptadine

6. MONITORING PARAMETERS

6A. Acute Phase Monitoring (Inpatient)

Parameter Frequency Target/Threshold Action if Abnormal ED HOSP OPD ICU
Spasm frequency and severity assessment (clinical scoring) Q4h (floor); Q1-2h (ICU) Decreasing frequency and severity Increase benzodiazepine dose; consider IV infusion or IVIg/PLEX; assess triggers STAT STAT - STAT
Respiratory status (SpO2, respiratory rate, work of breathing) Continuous (ICU); Q4h (floor) SpO2 >94%; RR 12-20; no accessory muscle use If desaturation or increased work of breathing: ABG; consider ICU transfer; intubation if respiratory failure STAT STAT - STAT
CK (creatine kinase) Q6-12h if spasms severe CK <1000 U/L If CK >5000: aggressive IV hydration; urine alkalinization; monitor for AKI; if >10,000: consider ICU STAT STAT - STAT
Renal function (BUN/Cr) Q12-24h; Q6h if rhabdomyolysis Stable creatinine If rising: increase hydration; hold nephrotoxics; nephrology consult URGENT URGENT - STAT
Urine output Q1h (ICU); Q4h (floor) >0.5 mL/kg/hr If oliguric with elevated CK: aggressive hydration; bicarbonate infusion; nephrology consult URGENT URGENT - STAT
Blood glucose Q6h if on steroids or T1DM comorbidity <180 mg/dL Insulin sliding scale; endocrine consult if persistent >250 STAT STAT - STAT
Sedation level (RASS or equivalent) Q2-4h if on high-dose benzodiazepines RASS 0 to -1 (alert to mildly sedated) If over-sedated: reduce benzodiazepine dose; assess for respiratory compromise; hold dose and reassess URGENT URGENT - STAT
Blood pressure and heart rate Q1h (ICU); Q4h (floor) SBP 100-160; HR 60-100 Autonomic instability: consider ICU; treat HTN crisis; assess for PERM variant STAT ROUTINE - STAT
Temperature Q4h; continuous in ICU 36.0-38.0C If hyperthermia with spasms: aggressive cooling; dantrolene; rule out infection; NMS differential STAT ROUTINE - STAT
Electrolytes (Na, K, Ca, Mg, Phos) Q12-24h; Q6h if rhabdomyolysis Normal ranges Correct abnormalities; hypokalemia and hypocalcemia worsen spasms URGENT ROUTINE - STAT

6B. Outpatient/Long-Term Monitoring

Parameter Frequency Target/Threshold Action if Abnormal ED HOSP OPD ICU
Neurological examination (rigidity, spasm frequency, gait, balance, functional status) Monthly x 6 months; then q3 months Stable or improving; functional independence maintained Treatment escalation; add immunotherapy; adjust symptomatic medications - - ROUTINE -
Functional status assessment (modified Rankin Scale, timed walk, activities of daily living) Q3 months Stable or improving Physical therapy intensification; medication adjustment; consider intrathecal baclofen if deteriorating - - ROUTINE -
Anti-GAD65 antibody titer (serum) Q6-12 months Stable or declining titers Rising titers may precede clinical relapse; consider treatment intensification (note: titer does not always correlate with disease activity) - - ROUTINE -
CBC with differential Monthly on immunosuppressants (mycophenolate, azathioprine); q2-4 months on rituximab WBC >3.0; ANC >1.5; Plt >100 Hold/reduce immunosuppression; growth factor if needed - - ROUTINE -
LFTs (ALT, AST, ALP, bilirubin) Monthly on azathioprine/mycophenolate; q3 months on other agents ALT/AST <3x ULN Dose reduction or switch agent - - ROUTINE -
Renal function (BUN/Cr) Q3 months; before each IVIg cycle Stable Dose adjustment; switch to sucrose-free IVIg product if renal function declining - - ROUTINE -
Quantitative immunoglobulins (IgG, IgA, IgM) Q6 months on rituximab; annually on other agents IgG >400 mg/dL Immunoglobulin replacement if recurrent infections with hypogammaglobulinemia - - ROUTINE -
CD19/CD20 B-cell counts Q3-6 months on rituximab B-cell depletion maintained Re-dose rituximab when B-cells reconstitute (>1% CD19) and clinical worsening - - ROUTINE -
Blood glucose and HbA1c Q3-6 months (T1DM comorbidity); more frequently if on steroids HbA1c <7% if diabetic Endocrine management; insulin adjustment; steroid dose reduction if possible - - ROUTINE -
Thyroid function (TSH) Annually Normal Thyroid hormone replacement if hypothyroid; endocrine referral - - ROUTINE -
DEXA scan (bone density) Baseline if steroids >3 months; repeat q1-2 years T-score >-2.5 Bisphosphonate therapy; calcium/vitamin D; endocrine referral - - ROUTINE -
Paraneoplastic cancer screening Annually for first 5 years if anti-amphiphysin positive; q2 years if anti-GAD only No malignancy Oncology referral if abnormal; intensify screening - - ROUTINE -
LFTs on tizanidine Baseline, 1, 3, 6 months, then periodically ALT/AST <3x ULN Discontinue tizanidine if significant hepatotoxicity - - ROUTINE -
Fall risk reassessment Q3-6 months No falls; safe mobility Adjust PT program; assistive devices; medication review (benzodiazepine dose optimization) - - ROUTINE -

7. DISPOSITION CRITERIA

Disposition Criteria
Discharge home Spasms controlled on oral medications; able to ambulate safely (with or without assistive device); ADLs independent or with available home support; no respiratory compromise; CK trending down; follow-up with neurology within 1-2 weeks; medication education completed; triggers identified and avoidance plan discussed; family/caregiver education completed
Admit to floor (neurology) New-onset SPS requiring diagnostic workup (LP, EMG, antibodies, imaging); uncontrolled spasms requiring IV benzodiazepines or medication titration; need for IVIg initiation; elevated CK from spasm-related rhabdomyolysis; functional decline requiring inpatient rehabilitation evaluation; new paraneoplastic workup needed
Admit to ICU Status spasticus (severe unrelenting spasms); respiratory compromise from chest wall rigidity; need for mechanical ventilation; rhabdomyolysis with CK >10,000 or acute kidney injury; autonomic instability; need for continuous benzodiazepine or propofol infusion; PERM variant with encephalopathy and autonomic dysfunction
Transfer to higher level of care Neuroimmunology specialist not available; neuromuscular EMG expertise not available; IVIg/plasmapheresis not available; intrathecal baclofen pump services not available; ICU care required when not available at current facility
Inpatient rehabilitation Significant functional impairment from rigidity and spasms; medically stable; expected to benefit from intensive PT/OT; unable to safely return home; needs supervised medication titration and mobility training
Outpatient follow-up All discharged patients: neurology follow-up within 1-2 weeks; labs per monitoring schedule; ongoing IVIg scheduling if initiated; physical therapy referral; paraneoplastic screening completion if not done inpatient
Readmission criteria Uncontrolled spasms despite medication compliance; respiratory difficulty; falls with injury; status spasticus; suspected rhabdomyolysis (dark urine, severe muscle pain after spasms); infection on immunosuppression

8. EVIDENCE & REFERENCES

Recommendation Evidence Level Source
IVIg for SPS (Class I RCT -- gold standard evidence for SPS immunotherapy) Class I, Level A Dalakas MC et al. N Engl J Med 2001;345:1870-1876
Anti-GAD65 antibodies as primary diagnostic marker for SPS (~80% positive) Class II, Retrospective Solimena M et al. N Engl J Med 1990;322:1555-1560
Clinical spectrum and natural history of SPS Class III, Retrospective Dalakas MC. Curr Treat Options Neurol 2009;11:102-110
Comprehensive review of SPS spectrum disorders (classic, SLS, PERM) Expert Review Dalakas MC. N Engl J Med 2024;390:1935-1948
EMG findings: continuous motor unit activity at rest in SPS Class II Gordon EE et al. Am J Med 1967;42:582-599
Original description of stiff-man syndrome (Moersch and Woltman) Historical Moersch FP, Woltman HW. Proc Staff Meet Mayo Clin 1956;31:421-427
Anti-amphiphysin antibodies and paraneoplastic SPS Class III De Camilli P et al. N Engl J Med 1993;328:546-551
Diazepam as first-line symptomatic treatment for SPS Expert Consensus Dalakas MC. Curr Treat Options Neurol 2009;11:102-110
Baclofen as adjunctive therapy for rigidity and spasms in SPS Class IV, Case Series Stayer C, Tronnier V. J Neurol 1997;244:244-245
Anti-glycine receptor antibodies in PERM variant Class III Carvajal-Gonzalez A et al. JAMA Neurol 2014;71:1009-1016
Anti-DPPX antibodies and hyperexcitability syndrome including SPS spectrum Class III Boronat A et al. Neurology 2013;80:1133-1139
Rituximab for SPS (case series showing benefit) Class IV, Case Series Dalakas MC et al. Ann Neurol 2017;82:271-277
Plasmapheresis for acute SPS exacerbations Class IV, Case Reports Shariatmadar S, Noto TA. J Clin Apher 2001;16:55-59
Intrathecal baclofen for refractory SPS Class IV, Case Reports Stayer C et al. J Neurol 1997;244:244-245
Association of SPS with type 1 diabetes mellitus (30-60% comorbidity) Class II, Retrospective Baizabal-Carvallo JF, Jankovic J. J Neurol 2015;262:2030-2040
Paraneoplastic SPS: cancer screening recommendations Expert Consensus Titulaer MJ et al. J Neurol Neurosurg Psychiatry 2008;79:1304-1306
High-titer anti-GAD (>2000 IU/mL) differentiates SPS from T1DM Class II Saiz A et al. Arch Neurol 2008;65:889-894
SPS and autoimmune comorbidities (thyroiditis, pernicious anemia, vitiligo) Class III Alexopoulos H, Dalakas MC. Neurol Neuroimmunol Neuroinflamm 2019;6:e571
Status spasticus as a medical emergency in SPS Class IV, Case Reports Stiff-person syndrome and status spasticus. Neurology 2008;71:2093-2094
CSF anti-GAD antibodies and intrathecal synthesis in SPS Class III Dalakas MC et al. Neurology 2001;57:780-784
Updated diagnostic criteria and classification of SPS spectrum Expert Review Newsome SD, Johnson T. J Neuroimmunol 2022;369:577915
Mycophenolate as immunosuppressive agent in SPS Class IV, Case Series Expert consensus; limited published evidence; extrapolated from autoimmune neurology practice
GABAergic pathway dysfunction as pathophysiology of SPS Class II, Basic Science Levy LM et al. N Engl J Med 1999;341:1511-1516

CLINICAL DECISION SUPPORT NOTES

Diagnostic Criteria for Stiff Person Syndrome (Dalakas Criteria)

All of the following must be present: - [ ] Progressive rigidity and stiffness of axial muscles (trunk, abdomen) and proximal limb muscles - [ ] Superimposed episodic spasms triggered by unexpected stimuli (noise, touch, emotional stress) - [ ] Continuous motor unit activity on EMG (in agonist and antagonist muscles simultaneously) - [ ] Absence of other neurological or cognitive signs to explain stiffness (normal brain/spine MRI) - [ ] Positive serology for anti-GAD65 antibodies (present in ~80%) or other SPS-associated antibodies - [ ] Response to benzodiazepines (supports diagnosis; not required)

SPS Spectrum Variants

Variant Key Features Antibodies Prognosis
Classic SPS Axial and proximal limb rigidity; episodic spasms; symmetric; anti-GAD65 positive Anti-GAD65 (~80%) Generally favorable with treatment; chronic course
Stiff-Limb Syndrome (SLS) Asymmetric limb rigidity; often one leg affected; may be focal Anti-GAD65 (variable) Moderate; may evolve to classic SPS
PERM Brainstem/spinal cord involvement; myoclonus; encephalopathy; autonomic dysfunction; most severe Anti-GlyR; Anti-DPPX; Anti-GAD65 Poorest; may be monophasic or relapsing
Paraneoplastic SPS Associated with cancer (breast, lung, thymoma); may be any phenotype Anti-amphiphysin (~100%); Anti-GAD65 (variable) Depends on tumor response; may improve with cancer treatment

Anti-GAD65 Titer Interpretation

Titer Range Clinical Significance
Negative (<5 IU/mL) Does not exclude SPS (seronegative variant exists); consider CSF testing
Low-moderate (5-2000 IU/mL) More commonly T1DM, autoimmune thyroiditis, cerebellar ataxia; less specific for SPS
High (>2000 IU/mL) Highly suggestive of SPS spectrum; also seen in anti-GAD cerebellar ataxia and autoimmune epilepsy
Very high (>10,000 IU/mL) Strongly associated with SPS; check for intrathecal synthesis

EMG Findings in SPS

  • Continuous motor unit activity (CMUA): Normal-appearing motor units firing continuously in agonist and antagonist muscles simultaneously at rest
  • Co-contraction pattern: Simultaneous activation of opposing muscle groups (e.g., paraspinal extensors and rectus abdominis)
  • No voluntary suppression: CMUA persists despite attempts to relax
  • Abolition with benzodiazepines: CMUA decreases or resolves with IV diazepam (diagnostic challenge)
  • Normal nerve conduction studies: NCS typically normal; no neuromyotonic discharges (distinguishes from Isaacs syndrome)
  • No denervation potentials: No fibrillations or positive sharp waves (distinguishes from motor neuron disease)

Red Flags Suggesting SPS

  • Progressive axial rigidity with preserved cognition
  • Episodic painful spasms triggered by startle or emotional stress
  • Hyperlordosis of lumbar spine with board-like abdominal muscles
  • Difficulty turning or bending at the waist
  • Falls without obvious cause (rigid legs "like walking on stilts")
  • Comorbid T1DM in patient with unexplained rigidity
  • Task-specific phobias (fear of walking, crossing streets) due to spasm anticipation
  • Normal brain MRI with prominent rigidity

Status Spasticus Emergency Protocol

  1. Immediate: Diazepam 10-20 mg IV push; may repeat q5-10 min
  2. If refractory: Midazolam 0.05-0.2 mg/kg/hr IV continuous infusion (ICU with intubation ready)
  3. If still refractory: Propofol infusion 20-50 mcg/kg/min (requires intubation)
  4. Concurrent: IV fluids for rhabdomyolysis prevention; CK monitoring; IVIg or PLEX if not recently administered
  5. Avoid: Abrupt benzodiazepine withdrawal; triggers (minimize stimulation, dark quiet room)
  6. Monitor: Continuous SpO2; CK q6h; renal function; electrolytes; temperature

CHANGE LOG

v1.1 (January 30, 2026) - Standardized all treatment table dosing to structured [dose] :: [route] :: [frequency] :: [full_instructions] format per C1-C4 - Section 3A: Fixed diazepam IV, lorazepam, midazolam, propofol, IV crystalloid, dantrolene dosing cells (M1) - Section 3B: Fixed diazepam PO, baclofen, gabapentin, pregabalin, tizanidine, clonazepam, levetiracetam, duloxetine, sertraline dosing cells (M2) - Section 3C: Fixed IVIg, plasmapheresis, botulinum toxin dosing cells (M3) - Section 3D: Fixed mycophenolate, azathioprine, prednisone dosing cells; rituximab and cyclophosphamide already correct (M4) - Added REVISED date to metadata

v1.0 (January 30, 2026) - Initial creation - Section 1: 18 core labs (1A), 19 extended labs (1B), 7 rare/specialized tests (1C) - Section 2: 6 essential imaging/studies (2A), 9 extended (2B), 4 rare/specialized (2C), 10 LP/CSF studies - Section 3: 4 subsections: - 3A: 6 acute/emergent treatments (diazepam IV, lorazepam, midazolam infusion, propofol, IV fluids, dantrolene) - 3B: 9 symptomatic treatments (diazepam PO, baclofen, gabapentin, pregabalin, tizanidine, clonazepam, levetiracetam, duloxetine, sertraline) - 3C: 4 second-line treatments (IVIg, plasmapheresis, intrathecal baclofen, botulinum toxin) - 3D: 5 disease-modifying/immunotherapy (rituximab, mycophenolate, azathioprine, prednisone, cyclophosphamide) with Pre-Treatment Requirements - Section 4: 14 referrals (4A), 13 patient instructions (4B), 12 lifestyle/prevention items (4C) - Section 5: 14 differential diagnoses with distinguishing features - Section 6: 10 acute monitoring parameters (6A), 14 outpatient/long-term monitoring parameters (6B) - Section 7: 7 disposition criteria - Section 8: 23 evidence references with PubMed links - Clinical Decision Support Notes: Dalakas diagnostic criteria, SPS spectrum variants table, anti-GAD titer interpretation, EMG findings summary, red flags checklist, status spasticus emergency protocol


APPENDIX A: SPS Treatment Algorithm

Step 1 - Symptomatic Therapy (ALL patients): - Diazepam 5 mg TID, titrate to 20-60+ mg/day (first-line) - Add baclofen 5 mg TID, titrate to 40-80 mg/day (adjunctive) - Add gabapentin/pregabalin if additional benefit needed

Step 2 - First-line Immunotherapy (most patients): - IVIg 2 g/kg over 5 days, repeat q4-6 weeks (Class I evidence) - Assess response at 3 months

Step 3 - Second-line Immunotherapy (IVIg failure or partial response): - Add rituximab 1000 mg x 2 (day 0, day 14), repeat q6 months - OR add mycophenolate/azathioprine as IVIg-sparing

Step 4 - Refractory Disease: - Plasmapheresis for acute flares - Intrathecal baclofen pump for medication-refractory rigidity - Cyclophosphamide as last resort

Step 5 - Paraneoplastic SPS: - Aggressive cancer screening and treatment - Immunotherapy as above - Tumor treatment may improve neurological symptoms

APPENDIX B: Anesthetic Considerations in SPS

Perioperative management is critical in SPS patients:

Consideration Recommendation
Benzodiazepines Do NOT withhold perioperatively; abrupt withdrawal triggers status spasticus
Anesthetic agents Regional anesthesia preferred when feasible; general anesthesia safe with appropriate monitoring
Neuromuscular blockers Depolarizing agents (succinylcholine) may trigger severe spasms -- AVOID; non-depolarizing agents safe
Propofol Safe and effective; GABAergic mechanism beneficial
Opioids Use cautiously; may exacerbate rigidity in some patients
Temperature Monitor closely; spasm-related hyperthermia possible
Positioning Careful positioning due to fixed rigidity; avoid forced range of motion
Postoperative Resume oral benzodiazepines as soon as possible; IV benzodiazepines if NPO; high risk for spasm exacerbation with pain/stress