Plasmapheresis in the Treatment of Stiff-Man Syndrome

To the Editor: We have previously reported¹ the presence of antibodies against glutamic acid decarboxylase in the serum and cerebrospinal fluid of a patient with stiff-man syndrome associated with type Ib diabetes mellitus and epilepsy. In February 1988 the patient was readmitted to our department for the occurrence in the preceding month of several episodes of diffuse muscular stiffness associated with apnea that were only partially relieved by intravenous diazepam (20 mg). On admission, the patient had the typical clinical and electromyographic features of stiff-man syndrome and was confined to bed. The presence of autoantibodies to glutamic acid decarboxylase was…