[Stiff man syndrome].

Our 51-year old patient developed low back pain and an increase of tonus mainly in the left limb and trunk muscles. Microscopic examination of the muscles and electronmicroscopic examination of the sural nerve and that of the gastronemic muscle did not show any specific deviation. On the basis of spontaneous activity observed during EMG examination, protracted motor activity of great amplitude when moved passively, as well as characteristic clinical symptoms and the disease process Stiff-man syndrome was diagnosed. Considering literature data, we tried applying diazepam (Seduxen and Rivotril)-presumably increasing the praesynaptic inhibition and affecting the reticular system of the brain stem-, as well as GABA medicaments (Lioresal and Depakine) increasing synaptic transport. By giving Seduxen, Rivotril and Baclofen simultaneously a lasting remission of symptoms could be reached. Applying Depakine in combination with the above medicines proved ineffective, presumably because of synergetic side effects.