Open AccessPisa syndrome in Parkinson’s disease: case description
Author(s) -
Renato Serquiz Elias Pinheiro,
Emanuelly da Costa Nobre Soares,
Maria Eduarda Bezerra Figueiredo,
Stella Mandu Cicco
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.644
Subject(s) - levodopa , medicine , botulinum toxin , context (archaeology) , benserazide , physical medicine and rehabilitation , trunk , physical therapy , dystonia , spasticity , pregabalin , parkinson's disease , rehabilitation , disease , anesthesia , psychiatry , paleontology , ecology , biology
Context: Pisa Syndrome (PS) is a rare postural disorder, characterized by dystonia of the trunk muscles, lateral deviation as well as rotation of the axial axis. There is a strong association with Parkinson’s disease (PD) due to the possible imbalance between neurotransmitters. It happens either due to a decrease in dopaminergic stimuli, either because of an excess of cholinergic stimuli or drugs (an example of antidopaminergics). The diagnosis is clinical, showing at least a 10-degree trunk flexion with improvement of pharmacological and non- pharmacological measures. Case report: A 60-year-old man was diagnosed with PD five years ago due to tipical clinical complaints and physical examination. The treatment recquired an increase of Pramipexole as well as the use of Levodopa and Benserazide. After two years, he complained about neck pain, low back pain, hip pain and a slight trunk twisting. After six months, his pain was worse and he reported right hemidystonia. Thus, he was diagnosed with PS associated with PD. It was decided to optimize the therapy with Pregabalin, muscle relaxants and rehabilitation. However, it did not show any good result. In 2020, the application of botulinum toxin (BTX) evidenced excellent results, improving both the pain and the spasticity of the patient. Conclusions: Early recognition is necessary to introduce the right treatment as soon as possible, especially BTX and rehabilitation, ensuring functionality and avoiding negative outcomes.