Mohd Fauzi, Nor Amelia; Mohd Nazi, Nisa Nadhira; Wan Mohd Azam, Ernie Rosmira; Bhatia, Kailash P; (2024) The One with Many Facets: Anti-Glycine Receptor Antibodies-Related Parkinsonism with Complex Visual Phenomena and Stiff-Limb Syndrome. Movement Disorders Clinical Practice , 11 (S2) S21-S25. 10.1002/mdc3.14144.

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Abstract

Anti-glycine receptor (GlyR) antibodies were first implicated in 2008 in a patient with progressive encephalomyelitis with rigidity and myoclonus (PERM).1 The clinical spectrum linked to this enigmatic antibody has since evolved to include stiff-person spectrum disorder (SPSD), which comprises classic stiff-person syndrome (SPS), stiff-limb syndrome (SLS), and SPS-plus variants.2, 3 Epilepsy and other neurological presentations (eg, encephalopathy, brainstem encephalitis, cerebellar ataxia, movement disorders, demyelination, and cognitive dysfunction) have also been described.2, 3 Parkinsonism and visual disturbances are recent emerging novel features of anti-GlyR antibodies (anti-GlyR-abs) syndrome.4, 5 Here, we report a patient with myasthenia gravis (MG) comorbid and positive anti-GlyR-abs presenting with parkinsonism, unusual visual phenomena, SLS, and hyperekplexia syndromes.

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