Acute pisa syndrome as a neurological emergency.

Abstract

To the Editor: Pisa syndrome is a rare clinical entity usually associated with underlying neurodegenerative diseases such as Parkinson’s disease and multiple system atrophy. However, it can also occur as an adverse effect of treatment with antipsychotics, especially in patients with predefined risk factors. Pisa syndrome is defined as sustained lateral flexion of the trunk.When observed in practice, it denotes an incapacitating symptom of underlying neurodegenerative diseases such as Parkinson’s disease and multiple system atrophy. Pisa syndrome can also occur as an adverse effect of prolonged treatment with antipsychotics, especially typical agents. However, reports describing acute drug-induced Pisa syndrome with possible treatment modalities are lacking. Here we report a patient with Alzheimer’s disease with severe risperidoneinduced acute Pisa syndrome in the neurological emergency room,whowas successfully treatedwith low-dose quetiapine.