Dear Debbie -
Understand that concern about the GAD65 in your blood-work. But I necessarily jump to wouldn't jump to any conclusions over it, especially where
to the best of my understanding, the only standard/generally-accepted treatments for Stiff Man/Person Syndrome (hereinafter SPS) are are essentially palliative therapies, and I've been on two of the biggies for years
in an attempt to deal with the spasms associated with CRPS: (1) CNS-focused muscle relaxants, e.g., Balcofen, and (2) benzodiazepines such as Xanax.
And here's the deal, as recently as 2008, articles were being published to the effect that "Analysis by LIPS of 40 sera samples from SPS and control subjects for anti-GAD65 antibodies revealed dramatic titer differences allowing diagnosis of SPS with 100% sensitivity and 100% specificity."
High definition profiling of autoantibodies to glutamic acid decarboxylases GAD65/GAD67 in stiff-person syndrome, Burbelo PD, Groot S, Dalakas MC, Iadarola MJ,
Biochem Biophys Res Commun. 2008 Feb 1;366(1):1-7.
But now we know that anti-GAD65 antibodies are found in a number of conditions, on account of which any claim of "100% specificity" of a diagnosis of SPS. See, e.g.,
GAD65 autoantibodies and its role as biomarker of Type 1 diabetes and Latent Autoimmune Diabetes in Adults (LADA), Towns R, Pietropaolo M,
Drugs Future. 2011 Nov;36(11):847
[I missed the reference to being tested for diabetes at the end of your last post - sorry]; AND
GAD65 Positive Autoimmune Limbic Encephalitis: A Case Report and Review of Literature, Sharma A, Dubey D, Sawhney A, Janga K,
J Clin Med Res. 2012 Dec;4(6):424-8.
Indeed, there has also been discussion is recent literature suggesting that earlier research may have
inverted the causation altogether, on account of which increased levels of GAD65 may be the
result and not the cause of neuro-ischemic pain and spasticity conditions in general.
Compare,
Epigenetic suppression of GAD65 expression mediates persistent pain, Zhang Z, Cai YQ, Zou F, Bie B, Pan ZZ,
Nature Medicine 2011 Oct 9;17(11):1448-55,
with,
Combinational spinal GAD65 gene delivery and systemic GABA-mimetic treatment for modulation of spasticity, Kakinohana O, Hefferan MP, Miyanohara A, Nejime T, Marsala S, Juhas S, Juhasova J, Motlik J, Kucharova K, Strnadel J, Platoshyn O, Lazar P, Galik J, Vinay L, Marsala M,
PLoS One Epub 2012 Jan 23.
And, for a general statement of that proposition - which I would encourage you to share with your doctors, see,
Calpain cleavage of brain glutamic acid decarboxylase 65 is pathological and impairs GABA neurotransmission, Buddhala C, Suarez M, Modi J, Prentice H, Ma Z, Tao R, Wu JY,
PLoS One Epub 2012 Mar 12.
But lets make this easy. Check out the Wikipedia article on
Stiff person syndrome . Here's what it list as the symptoms:
People with stiff person syndrome tends to present in 3 different stages: early, late and end stage. In the early stages, there are few objective findings indicating SPS during the initial assessment. SPS will begin insidiously in the axial muscles. Patients will present with an exaggerated upright posture and have stiffness and pain in the whole back. Sleep disturbances are also common due to muscle spasms waking them. In the late stages, proximal limb muscle become involved and the patient tends to move slower as fast movements will cause the severe spasms. Emotions such as anger have been shown to have a link to causing the spasms, which begin in this stage. Exaggerated lumbar lordosis becomes more evident in the patients. Depression can be comorbid with SPS at this stage due to the patient’s quality of life decreasing. In the end stage, activities of daily living such as eating and simple movements become hard to perform. Skeletal fractures and muscle ruptures occur quite often along with joint deformities. [Footnotes omitted.]
Funny, but I don't see a lot of references to disproportionate and/or burning pain, edema, discoloration, skin temperature changes across the body, etc.
Debbie - You and I have been on these forums for a long time. And I can pretend I recall every post you've put up along the way, but I have to think that a number of your complaints had nothing to do with SPS. IF AND ONLY IF that is the case, then I suspect it's probably more appropriate to consider your elevated levels of GAD65 as the EFFECT if your pain, spasm and rigidity, rather than the other way around.
I hope this is useful.
Mike