Noda Kazuyuki, Ando Maya, Jo Takayuki, Hattori Anri, Ogaki Kotaro, Sugiyama Mizuho, Hattori Nobutaka, Okuma Yasuyuki
Department of Neurology, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan.
Department of Neurology, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan.
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104882. doi: 10.1016/j.jstrokecerebrovasdis.2020.104882. Epub 2020 May 13.
Pisa syndrome is usually seen in patients with Alzheimer's disease treated with a cholinesterase inhibitor, dementia with Lewy bodies, Parkinson's disease, or atypical parkinsonism including multiple system atrophy. An 86-year-old woman presented with an acute onset of lateral flexion of her trunk to the left side, i.e., Pisa syndrome. She also showed left hemiparesis predominantly in her lower extremity. Her diffusion-weighted magnetic resonance images showed acute infarction in the right premotor area and supplementary motor area. Clopidogrel (75 mg daily) was prescribed. After two weeks from the onset of symptoms, her Pisa syndrome improved. The pathophysiology of Pisa syndrome has not yet been fully understood, but different mechanisms have been assumed. In this patient, it is possible that the infarction in her unilateral frontal lobe impaired the information processing from the temporoparietal cortex to the frontal lobe, including the premotor area and supplementary motor area for anticipatory postural control.
Pisa综合征通常见于接受胆碱酯酶抑制剂治疗的阿尔茨海默病患者、路易体痴呆、帕金森病或包括多系统萎缩在内的非典型帕金森综合征患者。一名86岁女性突然出现躯干向左侧的侧屈，即Pisa综合征。她还表现出以左下肢为主的左侧偏瘫。她的弥散加权磁共振成像显示右运动前区和辅助运动区急性梗死。给予氯吡格雷（每日75毫克）治疗。症状出现两周后，她的Pisa综合征有所改善。Pisa综合征的病理生理学尚未完全明确，但已假定存在不同机制。在该患者中，单侧额叶梗死可能损害了从颞顶叶皮质到额叶的信息处理，包括用于预期姿势控制的运动前区和辅助运动区。
