Date: Thursday, June 23, 2016
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To study of Pisa syndrome in Parkinson’s disease.
Background: Although Pisa syndrome and scoliosis are sometimes used interchangeably to describe a laterally flexed postural deviation in Parkinson’s disease (PD), the imaging findings of Pisa syndrome in PD have not been previously studied in detail.
Methods: Patients with PD and Pisa syndrome (lateral flexion >10° in the standing position) were examined clinically and underwent radiological assessment using standing radiograph and supine CT scan of the whole spine.
Results: The study included 15 patients. All patients had scoliosis on standing radiographs, and 12 had scoliosis persisting in the supine position. Scoliotic curves improved by a mean of 44% when patients moved from standing to supine. Only a quarter of patients with structural scoliosis had evidence of bony fusion on the side of their lateral deviation rendering their deformity fixed. The mean percentage of scoliosis attributed to collapse of posture on standing was 44%. This was significantly greater in the patients with mobile scoliosis (69%) versus those with a structural scoliosis (38%) (p=0.02). On examination none of the patients with Pisa syndrome had any evidence of dynamic dystonia although paraspinal electromyography did not form part of the study. Severity of posture as scored by the UPDRS III was scored as moderate in three patients and severe in 12, and the mean angle of lateralflexion was measured at 17° from the vertical.
Conclusions: Pisa syndrome describes a patient who lists to the side whereas scoliosis is defined by spinal curvature and rotation and may not be associated with lateral flexion. Thefinding of ‘structural scoliosis’ in Pisa syndrome should not preclude intervening to improve posture as most patients had little or no evidence of structural bony changes even when the deformity had been present for a number of years.
To cite this abstract in AMA style:E.I. Giyazitdinova, B.T. Muinjonov, G.S. Rakhimbaeva, Y.A. Musaeva, F.K. Shermukhamedova. Pisa syndrome in Parkinson’s disease: A mobile orfixed deformity? [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/pisa-syndrome-in-parkinsons-disease-a-mobile-orfixed-deformity/. Accessed September 25, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/pisa-syndrome-in-parkinsons-disease-a-mobile-orfixed-deformity/