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February 20, 1967


JAMA. 1967;199(8):576-577. doi:10.1001/jama.1967.03120080110022

In the spectrum of spastic disorders there exists a group of patients with remarkable axial stiffness, sometimes with superimposed muscle spasms, in whom no pathological lesions have been found. These patients do not have the atrophy and multiple-system disorders of polymyositis and other myopathies; their muscle spasms are sometimes of such force as to break long bones (thus excluding a diagnosis of hysteria); they have no dystonic posturing or other extrapyramidal features; myelography and spinal fluid examination disclose no abnormality (eliminating spinal cord tumor and meningitis)—although all of these diseases may mimic the problem.

In 1956, Moersch and Woltman described this group of patients under the heading of the "stiffman" syndrome.1 Olafson and associates established the limits of the syndrome more clearly in 1964.2 They emphasized that the problem is a chronic one, although the duration of illness in some patients is as short as six to nine