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May 2, 1977

Stiff-Man Syndrome and Clonazepam

JAMA. 1977;237(18):1930. doi:10.1001/jama.1977.03270450020010

To the Editor.—  In 1956, Moersch and Woltman1 first described the stiffman syndrome, a disease characterized by progressive fluctuating muscular rigidity and spasm. By now, more than 50 cases are known in the literature, two of which were reported in The Journal (195:222, 1966). Gordon et al2 made a thorough survey of the syndrome in 1967. Diazepam in high dosages, usually around 40 to 60 mg/day, has been the only known treatment, with considerable relief of symptoms in a majority of cases. Mertens and Ricker3 have also found clinical improvement after administration of γ-amino-β-hydroxybutyric acid derivatives. I report a patient who had good clinical improvement after receiving the new benzodiazepine derivative, clonazepam.

Report of a Case.—  A 55-year-old diabetic woman was admitted to the hospital in April 1976 with the diagnosis of drug abuse. She had been found to consume up to 40 mg diazepam (Valium) daily.