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Recurrent and Alternating Pisa Syndrome.

Alejandro Pellene¹, Michel Saenz-Farret, Federico Micheli

¹Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital de Clínicas "Jose de San Martin," Buenos Aires, Argentina.

Clinical Neuropharmacology

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Summary

This study details a Parkinson disease patient experiencing alternating Pisa syndrome (PS), first to the right, then to the left. Findings suggest denervation alone doesn't explain PS, indicating other factors are involved.

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Area of Science:

Neurology
Movement Disorders

Background:

Parkinson disease (PD) is a progressive neurodegenerative disorder.
Pisa syndrome (PS) is a rare postural abnormality characterized by involuntary trunk deviation.

Observation:

A 71-year-old male patient with PD developed right-sided PS while on dopaminergic therapy.
After treatment adjustment, the patient later developed left-sided PS, which did not resolve upon dopamine agonist discontinuation.

Findings:

This case presents the first documented instance of recurrent, alternating Pisa syndrome.
The patient's alternating PS episodes suggest mechanisms beyond simple denervation contribute to its development.

Implications:

Further research is needed to elucidate the complex pathophysiology of Pisa syndrome.
Understanding these mechanisms is crucial for developing targeted therapeutic strategies for PD patients with postural abnormalities.