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Botulinum Toxin Type A and Physiokinesiterapy in the Treatment of Pisa Syndrome
Marvulli R*, Mastromauro L, Falcicchio ML, Gallo GA, Napolitano M, Schivardi E, Fiore P, Megna M and Ianieri GDepartment of Basic Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Italy
- *Corresponding Author:
- Marvulli R
Department of Basic Sciences
Neuroscience and Sense Organs University of Bari Aldo Moro, Italy
Tel: 393395238606
E-mail: ricmarv81@hotmail.it
Received date: June 27, 2017; Accepted date: July 20, 2017; Published date: July 27, 2017
Citation: Marvulli R, Mastromauro L, Falcicchio ML, Gallo GA, Napolitano M, et al. (2017) Botulinum Toxin Type A and Physiokinesiterapy in the Treatment of Pisa Syndrome. J Alzheimers Dis Parkinsonism 7:354. doi:10.4172/2161-0460.1000354
Copyright: © 2017 Marvulli R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction: Pisa syndrome (PS) is a lateral axial dystonia (LAD) characterized by contraction of the trunk muscles that results in a marked tonic lateral flexion of the thoraco-lumbar. PS has been described among symptoms of tardive neuroleptic dystonia, in patients with dementia treated with cholinesterase inhibitors, in patients with idiopathic primary dystonia, in patients with Parkinson’s disease (PD), Alzheimer’s disease and multiple system atrophy. Unlike most of motor PD symptoms, PS is not significantly improved by dopaminergic medications or surgery. In this study we demonstrated efficacy of botulinumtoxinA and physiotherapy in patients with PS post PD due to paraspinal muscles overactivity. Material and methods: ten patients evaluated until 6 months after treatment with 100U of IncobotulinumtoxinA (Xeomin®, Merz Pharma) in the paraspinal muscles and physiotherapy. We assessed baropodometric exam, goniometric measurement and VAS scale. Results: Data demonstrated statistical improvement (p<0,05) until 6 months after treatment in all evaluation examined. Conclusion: BotulinumtoxinA and physiotherapy treatments were well-tolerated and effective and could be considered a possible treatment in parkinsonian patients with LAD.
