From The Taglierre School of Medicine Professional Guide to Diseases, 61st edition, Taglierre University Press, Year MDCCCLXXX of the Imperium, in the reign of the August Imperator Antonia IV.

Gerstman-Straussler Syndrome

(Grey shakes, Quivering fever)

Gerstman-Straussler Syndrome is a rare, acute infection caused by a prion-based agent. It causes mild to severe neurological impairment. It is rarely fatal, but if untreated can lead to blackouts and subsequent risk of injury or death.

Causes and Incidence

Gerstman-Straussler Syndrome is caused by a prion-based agent apparently produced at some point during the life cycle of the Kermishan fieldpup. G-S is usually transmitted by inhalation, ingestion (of contaminated food or water, for example), contact with fieldpup excrement, or fieldpup bites. Transmission from person to person or by mosquito, flea, or other arthropods had not been reported.

Signs and Symptoms

Signs and symtoms of G-S may be transient, or they may last for hours or tendays. They may appear and disappear with no predictable pattern, vary from day to day, and be bizarre a difficult for the patient to describe.

Visual problems and sensory impairment are among the first symptoms in most patients, often accompanied by numbness and tingling sensations (paresthesia) in the extremities. Mild spasticity is often observed, growing more pronounced as the disease progresses.

Other characteristic symptoms include:

Poorly articulated or scanning speech is often an associated symptom, as is dysphagia. Clinical effects may be so mild that the patient is largely unaware of them, or so bizarre that the patient appears hysterical.


A history of exposure to contaminated soil or water in an endemic area, contact with Kermishan fieldpups, or visits to Kermish (especially outside urban areas) is indicative of G-S Syndrome. Detection of the prion-based infectious agent, correctly matched with templates in standard diagnostic databases, is a confirming diagnosis.


Treatment consists of I.V. or I.M. administration of Gerstman-Straussler antiprion (available through Imperium Disease Control), continuing for 3 to 5 tendays. ACTH and corticosteroids may relieve symptoms and hasten remission. During acute exacerbations, supportive measures include bed rest, comfort measures such as massages, prevention of fatigue, administration of antibiotics or antivirals for bladder infections, physical therapy, and counseling.

Special considerations

copyright © 2003, Don Sakers
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