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Supportive ancillary findings include (1) the demonstration of continuous muscle activity in trunk and proximal limb muscles despite attempted relaxation, (2) enhanced exteroceptive reflexes, and (3) antibodies to glutamic acid decarboxylase (GAD) in both serum and spinal fluid. Antibodies to GAD are not diagnostic or specific for SMS and the role of these autoantibodies in the pathogenesis of SMS\/SLS\/PERM is the subject of debate and difficult to reconcile on the basis of our present knowledge. Nevertheless, evidence is emerging to suggest that SMS\/SLS\/PERM are manifestations of an immune\u2010mediated chronic encephalomyelitis and immunomodulation is an effective therapeutic approach. \u00a9 2002 Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.10279","type":"journal-article","created":{"date-parts":[[2002,10,9]],"date-time":"2002-10-09T01:25:39Z","timestamp":1034126739000},"page":"853-866","source":"Crossref","is-referenced-by-count":249,"title":["Stiff man syndrome and related conditions"],"prefix":"10.1002","volume":"17","author":[{"given":"Hans\u2010Michael","family":"Meinck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip D.","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2002,7,23]]},"reference":[{"key":"e_1_2_13_2_2","first-page":"421","article-title":"Progressive fluctuating muscular rigidity and spasm (stiff\u2010man syndrome): report of a case and some observations in 13 other cases","volume":"31","author":"Moersch FP","year":"1956","journal-title":"Mayo Clin Proc"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199005313222202"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1971.00480310050004"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00868343"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.10.1531"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5065.265"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5071.645"},{"key":"e_1_2_13_9_2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1001\/jama.1966.03100030116038","article-title":"Stiff man syndrome. 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