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Why is stiffness most common in middle-aged people? What are the reasons behind it?
Stiff-person syndrome (SPS), also known as Stiff-person syndrome, is a rare neurological disease whose cause is still unknown. The disease is characterized by progressive muscle stiffness and tightness, primarily affecting trunk muscles, and is accompanied by spasms that lead to postural distortion. Common symptoms include chronic pain, impaired mobility, and excessive lumbar lordosis. The disease occurs in about one in every million people and is most commonly found in middle-aged people.
Patients with stiffness syndrome often exhibit high levels of glutamic acid decarboxylase (GAD) antibodies, which are extremely rare in the general population.
Studies have shown that GAD antibodies are detected in about 80% of patients with stiffness, while in the general population, this figure is only 1%. Although GAD antibodies are commonly found in people with stiffness, not all people with GAD antibodies develop stiffness, suggesting that GAD antibodies are not the only cause of the disease. Stiff person syndrome was first described by Morsch and Waterman in 1956, and over the following decades iconic diagnostic criteria were developed and adjusted.
Symptoms and types
Stiffness can generally be divided into multiple types, including classic stiffness, cases related to other autoimmune diseases, and some variants of stiffness. Patients with classic stiffness syndrome often first experience muscle tightness or pain. As the disease progresses, stiff muscles gradually limit the range of motion, which may lead to difficulty in movement and abnormal posture, especially excessive forward curvature of the lumbar spine.
The muscle stiffness in people with stiffness may eventually spread from the trunk to the limbs, leading to unsafe falls where the person is unable to use their arms to lessen the impact of the impact.
In addition, many people with stiffness develop muscle spasms as the condition worsens. These spasms are often triggered by sudden movements or fright. Along with muscle stiffness, many patients experience other painful symptoms, including chronic pain and mood swings.
Cause analysis
The abnormal increase in GAD antibodies in patients with stiffness syndrome has attracted widespread attention from pathologists. This highlights the impact that the autoimmune system may have on muscle function. Despite this, the specific mechanism of action of GAD antibodies is still unclear. Current research shows that these antibodies may interfere with the function of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), thereby causing muscle stiffness and spasm.
The abnormal discharge of motor neurons in patients with stiffness is closely related to GABA dysfunction.
It is still not possible to confirm whether GAD antibodies are the cause of stiffness, but it is certain that the presence of GAD antibodies plays an important role in the diagnosis process.
Diagnosis and Treatment
The diagnosis of stiffness usually relies on the evaluation of clinical symptoms and the exclusion of other conditions, which involves extensive blood testing and electromyography. Although the rarity of stiffness often results in patients waiting years for a diagnosis, most people with stiffness experience remission of symptoms with appropriate treatment.
At present, the main drugs used to treat stiffness include benzodiazepines and immunotherapy.
Although there are currently no evidence-based treatments for stiff-legged syndrome, treatment focuses on symptom management and improving patients' quality of life. Physical therapy has also proven helpful for many patients.
Prognosis and Epidemiology
The prognosis of stiffness depends on whether it is a typical or atypical form and the presence of comorbidities. Early recognition and neurological treatment can limit the progression of the disease. About 65% of patients with rigor mortis are eventually unable to live independently, and as the condition worsens, their quality of life generally declines.
Although pliable therapy is beneficial for some patients, about 10% of patients are still at risk of acute crisis or even death, usually due to metabolic acidosis or autonomic crisis.
Conclusion
Current research continues to explore the causes and treatments of stiffness, but the high incidence of this disease among middle-aged people has undoubtedly attracted more attention from the scientific research community. Will the truth behind this mysterious disease be revealed in the future, as well as an effective treatment plan? This is an urgent question that all relevant people need to answer.
