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Parkinsonism with Pisa Syndrome

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Chapter
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Lateral flexion of the trunk in parkinsonism, originally described as scoliosis due to parkinsonism, refers to a lateral deviation of the spine with a corresponding tendency to lean to one side which occurs in patients with relatively advanced parkinsonism. The direction of postural deviation and concavity of the scoliosis are usually contralateral to the side of greater parkinsonian signs. “Pisa syndrome” was originally used to describe a rare form of acute or tardive dystonia associated with treatment with antipsychotic drugs. The typical clinical feature is a tonic lateral flexion of the trunk associated with mild backward rotation. The head and neck may also be involved.

Keywords

Antipsychotic Drug Multiple System Atrophy Lateral Deviation Rare Form Postural Deviation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

9 Parkinsonism w. Pisa syndrome.mp4 (MP4 7,595KB)

Examination shows lateral flexion of the trunk to the right side while seated which is sustained and unchanged when the patient performs various motor tasks. She displays facial masking, severe hypokinesia during finger tapping, and perioral tremor.

References

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    Di Matteo A, Fasano A, Squintani G, et al. Lateral flexion in Parkinson’s disease: EMG features disclose two different underlying pathophysiological mechanism. J Neurol. 2010; 258:740–5.PubMedCrossRefGoogle Scholar
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    Duvoisin RC, Marsden CD. Note on the scoliosis of parkinsonism. J Neurol Neurosurg Psychiatry. 1975;38:787–93.PubMedCentralPubMedCrossRefGoogle Scholar
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    Yokochi F. Lateral flexion in Parkinson’s disease and Pisa syndrome. J Neurol. 2006;253 Suppl 7:17–20.Google Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

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