Stiff-Man Syndrome and Encephalomyelitis

ABOUT 40 cases of the stiff-man syndrome (SMS) have been reported,1-14including the original description by Moersch and Woltman.2The etiology is unknown, and direct evidence of the morphological substrate is still lacking; reported autopsies showed negative findings.2,9,10,13We have seen typical SMS caused by an inflammatory process involving the lower brain stem and spinal cord, with features of viral encephalomyelitis. Report of a Case A 49-year-old widow, a store worker, was admitted to the neurological department on May 9, 1968, because of painful spasms and stiffness of the arms, shoulders, and legs. She had had typhus in childhood and arthritis beginning in childhood with recurrence in 1959 and 1963. Because of frequent sore throats and signs of myocarditis, tonsillectomy was performed in 1960. Her sister had tuberculosis. The history of her only daughter is described below. The present illness began in September 1967 with sacral