Related Experiment Video
Updated: May 5, 2026
09:35
Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
19.0K
Stiff-person spectrum disorder induced by shingles: a case report
Sawako Sakai1, Mitsuki Kyoya1, Yuki Kobayashi1
1Department of Neurology, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
BMJ Neurology Open
|December 9, 2025
Summary
Stiff-person spectrum disorder (SPSD) can be triggered by infections like herpes zoster. Early immunotherapy and pain management are crucial for recovery from infection-related SPSD.
Area of Science:
- Neurology
- Immunology
- Infectious Diseases
Background:
- Stiff-person spectrum disorder (SPSD) is a rare autoimmune neurological condition.
- It presents with progressive rigidity, muscle co-contractions, and spasms.
- A small percentage (5-10%) of SPSD cases are paraneoplastic, with fewer reported infection-related cases.
Purpose of the Study:
- To report a case of SPSD following herpes zoster infection.
- To explore the potential mechanisms linking herpes zoster pain to SPSD exacerbation.
- To highlight the importance of integrated treatment approaches for infection-triggered SPSD.
Main Methods:
- Case study of a 56-year-old female patient.
- Clinical assessment of symptoms including spasms, autonomic dysfunction, and antibody levels.
- Treatment involved immunotherapy (intravenous immunoglobulin, methylprednisolone), benzodiazepines, and epidural analgesia.
Main Results:
- The patient developed SPSD symptoms eight days after herpes zoster rash onset.
- Elevated anti-glutamic acid decarboxylase antibodies were detected in serum and cerebrospinal fluid.
- A 3-month course of immunotherapy and supportive care led to gradual symptom improvement.
Conclusions:
- Herpes zoster pain may worsen SPSD by amplifying muscle co-contractions through reflex pathways.
- Impaired reciprocal inhibition is a key feature of SPSD that can be exacerbated by pain.
- Optimal pain control alongside immunotherapy is recommended for SPSD cases triggered by infection.
Related Concept Videos
01:28Disorders of the Skeletal Muscle
2.2K
The clinical conditions affecting the skeletal muscle tissue are broadly categorized as musculoskeletal and neuromuscular disorders.
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
2.2K
01:23Rheumatic Heart Disease I: Introduction
1.0K
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
1.0K
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
1.3K
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
1.3K
01:19Multiple Sclerosis l: Introduction
20
Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
20
01:27Degenerative Disc Disease I: Introduction
29
Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
29
01:23Degenerative Disc Disease ll: Pathophysiology
30
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
30