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Neurocysticercosis — SCE Neurology MCQ

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HardCNS InfectionsNeurocysticercosisSCE Neurology

A 55-year-old man develops severe stimulus-sensitive rigidity and myoclonus, fluctuating encephalopathy, dysautonomia, dysphagia and ophthalmoparesis. MRI is nearly normal. Which antibody result best fits this stiff-person-spectrum phenotype?

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Correct answer: E — Glycine-receptor antibody supporting progressive encephalomyelitis with rigidity and myoclonus

Explanation lettering: C = shown as B · D = shown as C · B = shown as D

E is correct: brainstem signs, dysautonomia, encephalopathy and prominent myoclonus superimposed on rigidity define PERM, most strongly associated with glycine-receptor antibodies. A fits classic SPS better and does not explain the full brainstem–autonomic syndrome. B misstates amphiphysin, which is linked to paraneoplastic stiff-limb/SPS. C and D can cause movement disorders but are not the characteristic antibody–phenotype pairing. PERM warrants prompt combined immunotherapy and supportive respiratory/autonomic care.

Reference: Stiff-person syndrome: https://pn.bmj.com/content/25/1/6