Two Cases of Pisa Syndrome Due to Cholinestrase Inhibitor

J Korean Neurol Assoc > Volume 18(4); 2000 > Article

Journal of the Korean Neurological Association 2000;18(4): 469-471.

콜린분해효소 억제제를 사용한 후 발생한 Pisa 증후군 2예

곽용태, ·한일우 ·백종삼*

용인효자병원 신경과,용인시 보건소*

Two Cases of Pisa Syndrome Due to Cholinestrase Inhibitor

Yong Tae Kwak, M.D., Il-Woo Han, M.D., Jongsam Baik, M.D.*

Department of Neurology, Yong-in Hyoja Geriatric Hospital, Yong In Public Health Center*

Abstract

The Pisa syndrome is a rare extrapyramidal side effect with twisting and bending characteristics of the upper trunk, neck, and head, usually caused by neuroleptic treatment. However, there have been no reports of Pisa syndrome in cholinesterase inhibitor therapy. We report 2 female patients of Alzheimer’s disease with Pisa syndrome after cholinesterase inhibitor ther-apy. The postural disturbance in these patients was completely resolved after the cessation of the cholinesterase inhibitor. Although the pathophysiology of Pisa syndrome appears to be extremely complicated and poorly understood, it may be of importance to consider the relationship between acetylcholine and Pisa syndrome. Therefore, the present cases provide a novel viewpoint on the underlying mechanism of the Pisa syndrome and the role of acetylcholine in the movement disorder. J Korean Neurol Assoc 18(4):469~471, 2000 Key Words : Cholinesterase inhibitor, Alzheimer disease, Pisa