{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T06:21:51Z","timestamp":1763706111129,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2021,7,7]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a subtype of stiff-person syndrome (formerly stiff-man syndrome). It is rare and disabling, and characterised by brainstem symptoms, muscle stiffness, breathing issues and autonomic dysfunction. We describe a 65-year-old man who presented with odynophagia together with tongue and neck swelling, followed by multiple cranial nerve palsies culminating in bilateral vocal cord paralysis with acute stridor. He subsequently developed progressive generalised hypertonia and painful limb spasms. Serum antiglycine receptor antibody was strongly positive, but antiglutamic acid decarboxylase and other antibodies relating to stiff-person syndrome were negative. We diagnosed PERM and gave intravenous corticosteroids and immunoglobulins without benefit; however, following plasma exchange he has made a sustained improvement.<\/jats:p>","DOI":"10.1136\/practneurol-2021-003087","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T13:25:50Z","timestamp":1627478750000},"page":"48-50","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Progressive encephalomyelitis with rigidity and myoclonus (PERM)"],"prefix":"10.1136","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1204-1710","authenticated-orcid":false,"given":"Neil","family":"Grech","sequence":"first","affiliation":[{"name":"Department of Medicine, Mater Dei Hospital, Msida, Malta"},{"name":"Edinburgh Medical School: Clinical Sciences, The University of Edinburgh College of Medicine and Veterinary Medicine, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Paul","family":"Caruana Galizia","sequence":"additional","affiliation":[{"name":"Department of Medicine, Gozo General Hospital, Victoria, Gozo, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Pace","sequence":"additional","affiliation":[{"name":"Department of Neurology, Gozo General Hospital, Victoria, Gozo, 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