26 patients age 25-80 with typical SPS as per Dalakas's diagnostic criteria (1,2) poorly or partially responding to IVIg or rituximab with declining benefits, exhibiting significant symptomatology of stiffness, painful muscle spasms, and impaired walking ability will be selected. All enrolled patients will be GAD-ab or Glycin-receptor-antibody-positive and will continue receiving the non-immunosuppressive symptomatic drugs, such as diazepam, gabapentin, or baclofen.
All selected patients will be among the large number we currently follow in our outpatient clinic or among those being continuously referred for a second opinion or better therapies when unresponsive to current drugs.
All patients should be able to provide informed consent and willing to travel for scheduled protocol visits.
You may not be if
Patients will be excluded if: a) have minimal disease, and less than 1 stiffness index; b) have very severe disease unresponsive to all therapies or non-ambulatory; and c) have paraneoplastic SPS.
