What is Pisa disease?

Idiopathic Pisa syndrome is characterised by an adult-onset, segmental truncal dystonia in patients with no previous exposure to antipsychotics. It occurs rarely but shows a complete resolution with high doses of anticholinergic drugs.

What causes Pisa syndrome?

Pisa syndrome is most commonly caused by drugs (e.g. neuroleptics, antiemetic, anticholinesterases)1 or neurodegenerative disorders (e.g., Parkinson, Multiple System Atrophy), though many cases remain idiopathic. The prevalence is 0.42%.

Is Pisa syndrome reversible?

Subsequently, development of Pisa syndrome has also been reported in patients receiving other drugs, in those with neurodegenerative diseases, or in idiopathic cases. We report the development of reversible Pisa syndrome in a patient with Parkinson’s disease (PD) during treatment with pergolide.

Is Pisa syndrome painful?

Truncal postural abnormalities such as camptocormia and Pisa syndrome, as well as Parkinson’s-related and -unrelated pain, are not uncommon in patients with Parkinson’s disease [1, 2], and medical treatment for these symptoms is often difficult.

How is Pisa syndrome related to Parkinson’s disease?

Pisa syndrome is defined as a reversible lateral bending of the trunk with a tendency to lean to one side. It is a frequent and often disabling complication of Parkinson’s disease, and has also been described in several atypical forms of parkinsonism and in neurodegenerative and psychiatric disorder …

Are there any drugs that treat Pisa syndrome?

Furthermore, several drugs are reported to induce Pisa syndrome, including antiparkinsonian drugs. As Pisa syndrome might be reversible, clinicians need to be able to recognise this condition early to enable prompt management. Nevertheless, further research is needed to determine optimum treatment strategies.

What are the diagnostic criteria for Pisa syndrome?

Although no consistent diagnostic criteria for Pisa syndrome are available, most investigations have adopted an arbitrary cutoff of at least 10° of lateral flexion for the diagnosis of the syndrome. Pathophysiological mechanisms underlying Pisa syndrome have not been fully explained.

How is Pisa syndrome characterized in deep sleep?

This disorder is characterized by “acting out” dreams during REM or deep sleep; it can include vocalizations and sudden, often violent, limb movement. Both of these characteristics were further found to be significantly associated with Pisa syndrome in statistical models.