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Volume 8 Journal of Palliative Care & Medicine
ISSN: 2165-7386 Geriatrics 2018
July 30-31, 2018
July 30-31, 2018 | Barcelona, Spain
8th International Conference on
Geriatrics Gerontology & Palliative Nursing
Pisa syndrome in elderly person-the pathogen and treatment of postural deformities
Masahiro Hayashi1 and Katsuji Kobayashi2
1Sakuragaoka Hospital, Japan
2Awazu Hospital, Japan
Pisa syndrome is one of the abnormal postures. The term Pisa syndrome is defined as a lateral bending of a trunk. The
mechanisms underlying Pisa syndrome have not been fully explained yet. It was originally considered as a consequence of
treatment with antipsychotics which induce a cholinergic-dopaminergic imbalance. Subsequently, the term has been generally
applied to trunk lateral deviation≥10°. Recently, it was reported that asymmetric functioning of basal ganglia could lead directly
to asymmetric regulation of postural muscle tone related to a lateral deviation. We investigated the two schizophrenic patients.
They developed Pisa syndrome while exposed to the long-term treatment with antipsychotics. In one case, 123I-FP-CIT dopamine
transporter-single photon emission tomography imaging disclosed asymmetrical DAT uptake in the stiratum, which may be
associated to asymmetric functioning of basal ganglia. Furthermore, it is possible that schizophrenic patients with Pisa syndrome
developed the similar dysfunction of basal ganglia due to the exposure of long-term dopamine D2-receptor blockade. Because
Pisa syndrome become irreversible condition in the advanced disease stages, early its recognition and the pharmacological
adjustment especially the dosage of antipsychotic drugs should be important. Furthermore, postural deformities such as Pisa
syndrome are frequent disabling complications of neurodegenerative diseases, especially Lewy body disease, frontotemporal
dementia. The postural deformities have a multifactorial pathophysiology. Because the effects of levodopa treatment are
limited, we have introduced botulinum toxin as therapeutic tool for the treatment of some neurological disorders. Botulinum
toxin treatment resulted in significant improvement of the tension of muscles related to abnormal postures. We report these
outcomes, including the pathogeny of Pisa syndrome and postural deformities this time.
Biography
Masahiro Hayashi is a Neurologist. He worked in a national hospital having an institute of neurology for fifteen years. He is a Specialist in Parkinson’s disease,
spinocerebellar degeneration and dementing disorders. He has made a study of neuropathology and neuroimaging. Currently, neuroimaging is his area of
specialization. He works as a Clinician at the Department of Neurology and Psychiatry in the private hospital in Japan.
Masahiro Hayashi et al., J Palliat Care Med 2018, Volume 8
DOI: 10.4172/2165-7386-C2-017