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Progressive Encephalomyelitis with Rigidity and Myoclonus: Anesthesia and Glycine Receptor Antibodies

Papadopoulou, Aikaterini MBBS; Samuels, Theophilus Luke MBBS; Dassanayake, Asitha MBBS; Spring, Colin MBBS; Willers, Johann MBChB; Uncles, David Roy MBBS

doi: 10.1097/ACC.0b013e3182a6d853
Case Reports: Case Report

Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a rare autoimmune neurological condition. Antibodies targeting glycine receptors (GlyR) have been implicated in PERM. Because GlyR activity is enhanced by inhaled anesthetic drugs at clinically relevant concentrations, there is a theoretical possibility that these drugs may be less effective in the presence of GlyR antibodies. We describe a case of general anesthesia in a patient with PERM and GlyR antibodies. This patient did not demonstrate a clinically significant alteration in the behavioral effects of anesthesia using induction of anesthesia with sevoflurane and maintenance of anesthesia using sevoflurane and nitrous oxide.

From the Department of Anesthesia, Worthing Hospital, Worthing, United Kingdom.

Accepted for publication July 11, 2013.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Aikaterini Papadopoulou, MBBS, Department of Anesthesia, Worthing Hospital, Lyndhurst Road, Worthing, West Sussex, BN11 2DH, United Kingdom. Address e-mail to

© 2014 International Anesthesia Research Society