ArticleJournal of neurology2025
Core diagnostic features of stiff person syndrome: insights from a case-control study.
Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comorbid autoimmune disease in stiff-person syndrome spectrum disorder: a systematic review and meta-analysis.Journal of neurology · 2026Pooled it
- Stiff Person Syndrome: Bridging Neuroimmunology and Rehabilitation for Improved Patient Outcomes.Archives of internal medicine research · 2026Article
- Stiff-Person Syndrome: A Comprehensive Review of a Rare Disease with Emphasis on Pathophysiology, Clinical Features, Diagnostic Challenges and Therapeutic Advances.The Yale journal of biology and medicine · 2026Review
- Case report of stiff - person syndrome and literature review.IBRO neuroscience reports · 2026Article
- Stiff-person syndrome following west nile virus infection in an immunocompromised patient.Journal of neurology · 2026Article
- Case Report: Efgartigimod: a beacon of hope for overlapping stiff-person syndrome and myasthenia gravis following thymoma.Frontiers in immunology · 2026Article
- Case Report: A case of influenza A infection-associated stiff person spectrum disorder with favorable outcome.Frontiers in immunology · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStiff person syndrome spectrum disorders (SPSD) are rare, disabling neuroimmunological conditions with no consensus diagnostic criteria, making diagnosis challenging. Misdiagnosis often occurs due to the limited awareness of atypical symptoms and presentations. This study aimed to identify key clinical and paraclinical features most predictive of classic SPS and SPS-plus diagnosis and misdiagnosis patterns.
methodsWe conducted a retrospective case-control study at Johns Hopkins SPS center, analyzing patient data from 1997-2021. A total of 154 classic SPS, 45 SPS-plus, and 66 control patients (evaluated for SPSD but given an alternative diagnosis) were included. Clinical assessments, autoantibody testing, electromyography (EMG), and other diagnostic studies were reviewed. Sensitivity, specificity, and diagnostic odds ratios were calculated, with logistic regression identifying the strongest diagnostic indicators of the SPS phenotypes.
resultsTorso/lower extremity symptoms, hypersensitivity triggers, paravertebral stiffness, and gait dysfunction were common in both phenotypes. Classic SPS was most specifically associated with high-titer GAD65 antibodies (98%), cerebrospinal fluid GAD65 positivity (100%), characteristic EMG abnormalities (> 90%), and hyperlordosis (87%). SPS-plus specificity was highest for cerebellar (98.5%) and brainstem (100%) signs/symptoms. High-titer GAD65 antibodies were the strongest independent diagnostic factor for both phenotypes. Misdiagnosis was most common in patients presenting with upper extremity, brainstem, or cerebellar involvement.
conclusionsRecognizing key diagnostic and misdiagnosis patterns may help clinicians make accurate and timely diagnoses of SPSD. This could help prevent misdiagnosis/overdiagnosis, ensure timely treatment, and assure appropriate patient populations are included in future interventional SPS clinical trials. Further studies are needed to validate these findings and refine diagnostic criteria.
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