Related Experiment Video
Updated: Jul 3, 2026
04:44
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Pisa syndrome.
Takeshi Uemura1, Yuichi Kasai, Kentaro Araki
1Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
Journal of Spinal Disorders & Techniques
|August 6, 2008
Summary
A patient developed Pisa syndrome, a form of drug-induced pleurothotonus, after taking clomipramine hydrochloride. Reducing the tricyclic antidepressant dosage resolved the abnormal trunk flexion, highlighting the importance of medication review.
Area of Science:
- Neurology
- Pharmacology
- Orthopedics
Background:
- Pisa syndrome, or drug-induced pleurothotonus, is a known condition in neuropsychiatry but less recognized by orthopedic and spinal surgery specialists.
- Tricyclic antidepressants, such as clomipramine hydrochloride, can cause extrapyramidal side effects.
Observation:
- A 56-year-old woman developed progressive leftward trunk flexion approximately two months after initiating clomipramine hydrochloride for depression.
- The patient's symptoms were consistent with Pisa syndrome.
Findings:
- Reducing the daily dose of clomipramine hydrochloride from 225 mg to 75 mg led to a gradual improvement in the patient's abnormal posture.
- Complete resolution of the trunk flexion occurred within one month of dose reduction.
Implications:
- This case highlights the potential for tricyclic antidepressants to induce Pisa syndrome, even in patients presenting to orthopedic specialists.
- Physicians, particularly orthopedic surgeons, should consider drug-induced causes like Pisa syndrome when evaluating patients with abnormal trunk postures.
- Inquiring about psychotropic or antiemetic medication use is crucial for diagnosing and managing Pisa syndrome.
More Related Videos
Related Concept Videos
01:11Pyloric Obstruction
Pyloric obstruction, also referred to as gastric outlet obstruction, is a condition characterized by narrowing or blockage at the pylorus—the muscular valve regulating the flow of stomach contents into the duodenum. When this passage becomes impaired, the stomach cannot effectively empty its contents into the small intestine. This disruption leads to a range of gastrointestinal symptoms, including early satiety, bloating, epigastric pain, postprandial nausea, persistent vomiting, and...
01:23Irritable Bowel Syndrome
DefinitionIrritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by recurrent combinations of abdominal pain, bloating, diarrhea, or constipation.Pathophysiology of irritable bowel syndromeIts pathophysiology is multifactorial, involving disturbances in motility, sensory processing, microbial balance, barrier integrity, and gut–brain communication. These mechanisms interact to produce symptoms that vary across IBS subtypes.Altered Motility PatternsDisordered...
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:29Pneumonia II: Pathophysiology
The pathophysiology of pneumonia involves the following steps:
01:14Atypical Pneumonia
Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease include...