Progressive encephalomyelitis with rigidity and myoclonus

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ORPHA:438266OMIM:184850G04.8
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Overview

Progressive encephalomyelitis with rigidity and myoclonus, often called PERM, is a rare neurological condition that affects the brain and spinal cord. It is closely related to stiff person syndrome but is generally more severe. In PERM, the immune system mistakenly attacks parts of the nervous system, leading to widespread inflammation in the brain (encephalitis) and spinal cord (myelitis). This causes increasing muscle stiffness (rigidity), sudden involuntary muscle jerks (myoclonus), and painful muscle spasms. Over time, patients may also develop difficulty walking, problems with eye movements, trouble swallowing, and issues with balance. Some people experience confusion, memory problems, or other changes in brain function. PERM is considered an autoimmune disorder, meaning the body's own immune system is the cause. Many patients have antibodies against specific proteins in the nervous system, most commonly antibodies against glycine receptors (GlyR antibodies) or glutamic acid decarboxylase (GAD antibodies). These antibodies interfere with normal nerve signaling, which leads to the characteristic stiffness and spasms. Treatment focuses on calming the immune system and managing symptoms. Immunotherapy — including corticosteroids, intravenous immunoglobulin (IVIG), and plasma exchange — is the main approach. Medications to reduce muscle stiffness and spasms, such as benzodiazepines and baclofen, are also commonly used. Early diagnosis and treatment can improve outcomes, but the disease can be life-threatening if not recognized and treated promptly. Some patients respond well to immunotherapy and experience significant improvement, while others may have a more progressive course.

Also known as:

Key symptoms:

Severe muscle stiffness throughout the bodySudden involuntary muscle jerks (myoclonus)Painful muscle spasms triggered by noise, touch, or movementDifficulty walking or inability to walkProblems with balance and coordinationDifficulty swallowingAbnormal eye movementsSlurred speechConfusion or changes in thinkingExaggerated startle responseBreathing difficultiesAutonomic problems such as sweating, rapid heart rate, or blood pressure changesSensory symptoms like numbness or tinglingAnxiety or fear related to spasms

Inheritance

Sporadic

Usually appears on its own, not inherited from a parent

Age of Onset

Adult

Begins in adulthood (age 18 or older)

Orphanet ↗OMIM ↗NORD ↗

FDA & Trial Timeline

1 event
Mar 2026Examining a Novel Gastrointestinal Intervention to Negate Environmental Toxicants (ENGINE)

University of California, San Francisco — PHASE1, PHASE2

TrialRECRUITING

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Treatments

No FDA-approved treatments are currently listed for Progressive encephalomyelitis with rigidity and myoclonus.

View clinical trials →

No actively recruiting trials found for Progressive encephalomyelitis with rigidity and myoclonus at this time.

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Search ClinicalTrials.gov ↗Join the Progressive encephalomyelitis with rigidity and myoclonus community →

No specialists are currently listed for Progressive encephalomyelitis with rigidity and myoclonus.

View NORD Rare Disease Centers ↗Undiagnosed Disease Network ↗

Treatment Centers

8 centers
🏥 NORD

Baylor College of Medicine Rare Disease Center

Baylor College of Medicine

📍 Houston, TX

🏥 NORD

Stanford Medicine Rare Disease Center

Stanford Medicine

📍 Stanford, CA

🔬 UDN

NIH Clinical Center Undiagnosed Diseases Program

National Institutes of Health

📍 Bethesda, MD

🔬 UDN

UCLA UDN Clinical Site

UCLA Health

📍 Los Angeles, CA

🔬 UDN

Baylor College of Medicine UDN Clinical Site

Baylor College of Medicine

📍 Houston, TX

🔬 UDN

Harvard/MGH UDN Clinical Site

Massachusetts General Hospital

📍 Boston, MA

🏥 NORD

Mayo Clinic Center for Individualized Medicine

Mayo Clinic

📍 Rochester, MN

👤 Mayo Clinic Center for Individualized Medicine

🏥 NORD

UCLA Rare Disease Day Program

UCLA Health

📍 Los Angeles, CA

Travel Grants

No travel grants are currently matched to Progressive encephalomyelitis with rigidity and myoclonus.

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Community

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Latest news about Progressive encephalomyelitis with rigidity and myoclonus

Disease timeline:

New recruiting trial: Examining a Novel Gastrointestinal Intervention to Negate Environmental Toxicants (ENGINE)

A new clinical trial is recruiting patients for Progressive encephalomyelitis with rigidity and myoclonus

Caregiver Resources

NORD Caregiver Resources

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Mental Health Support

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Family & Caregiver Grants

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Social Security Disability

Learn how rare disease patients may qualify for SSDI/SSI benefits.

Questions for your doctor

Bring these to your next appointment

  • Q1.What type of antibodies were found in my tests, and how does that affect my treatment plan?,Should I be screened for an underlying cancer that could be causing this condition?,What immunotherapy options are available, and what are the risks and benefits of each?,How will we know if the treatment is working, and how often will I need follow-up testing?,What should I do if I experience a sudden worsening of stiffness or breathing difficulty?,Will I need long-term immunosuppressive treatment, and what are the side effects?,Are there clinical trials or specialized centers for this condition that I should consider?

Common questions about Progressive encephalomyelitis with rigidity and myoclonus

What is Progressive encephalomyelitis with rigidity and myoclonus?

Progressive encephalomyelitis with rigidity and myoclonus, often called PERM, is a rare neurological condition that affects the brain and spinal cord. It is closely related to stiff person syndrome but is generally more severe. In PERM, the immune system mistakenly attacks parts of the nervous system, leading to widespread inflammation in the brain (encephalitis) and spinal cord (myelitis). This causes increasing muscle stiffness (rigidity), sudden involuntary muscle jerks (myoclonus), and painful muscle spasms. Over time, patients may also develop difficulty walking, problems with eye movemen

How is Progressive encephalomyelitis with rigidity and myoclonus inherited?

Progressive encephalomyelitis with rigidity and myoclonus follows a sporadic inheritance pattern. Genetic counseling can help families understand recurrence risk and testing options.

At what age does Progressive encephalomyelitis with rigidity and myoclonus typically begin?

Typical onset of Progressive encephalomyelitis with rigidity and myoclonus is adult. Age of onset can vary across affected individuals.