What Is Stiff Person Syndrome (SPS)?

Stiff Person Syndrome (SPS) is a rare autoimmune neurological condition.

In autoimmune conditions, the immune system mistakenly attacks parts of the nervous system.

Classic SPS typically causes:

  • Persistent muscle stiffness (often in the trunk and legs)

  • Painful muscle spasms

  • Heightened startle response

  • Difficulty walking

  • Increased muscle tone

Symptoms often develop gradually.

Many people with classic SPS have antibodies such as anti-GAD antibodies, although not everyone does.

SPS can be serious, but in its classic form it usually progresses slowly.

What Is PERM?

Progressive Encephalomyelitis with Rigidity and Myoclonus

It is considered a more severe form within the SPS spectrum.

Breaking down the name:

  • Progressive – symptoms worsen over time

  • Encephalo- – brain involvement

  • Myelitis – spinal cord involvement

  • Rigidity – severe stiffness

  • Myoclonus – sudden muscle jerks

PERM can involve:

  • Severe whole-body stiffness

  • Repeated spasms

  • Brainstem symptoms

  • Swallowing or speech difficulty

  • Abnormal heart rate or breathing

  • Autonomic instability

  • Risk of life-threatening complications

PERM is often associated with anti-glycine receptor antibodies, although not always.

How Are SPS and PERM Different?

Classic SPS mainly affects muscle tone and stiffness.

PERM involves the brainstem and autonomic nervous system, which can affect:

  • Breathing

  • Heart rhythm

  • Blood pressure

  • Swallowing

  • Consciousness

PERM tends to progress more quickly and can become critical without treatment.