RESUMO
TITLE: Sindrome de Pisa asociado a codeina.
Assuntos
Codeína/efeitos adversos , Distúrbios Distônicos/induzido quimicamente , Acetaminofen/uso terapêutico , Idoso , Analgésicos/efeitos adversos , Analgésicos/uso terapêutico , Dor nas Costas/tratamento farmacológico , Dor nas Costas/etiologia , Neoplasias da Mama/terapia , Carcinoma Lobular/secundário , Codeína/uso terapêutico , Substituição de Medicamentos , Quimioterapia Combinada , Distúrbios Distônicos/diagnóstico , Feminino , Humanos , Cetorolaco/uso terapêutico , Neoplasias da Coluna Vertebral/secundário , SíndromeRESUMO
We report the case of a 29-year-old male patient with a generalized and progressive dystonia that led him unable to stand. Multiple antidystonic treatments were tried without benefit. Alcohol test was positive with a dramatic improvement. To the best of our knowledge, this is the first reported case of generalized dystonia without other clinical manifestations sensitive to alcohol.
Assuntos
Álcoois/efeitos adversos , Depressores do Sistema Nervoso Central/efeitos adversos , Distúrbios Distônicos/induzido quimicamente , Adulto , Humanos , Masculino , Índice de Gravidade de DoençaRESUMO
OBJECTIVES: The aims of the study were to report the case of a male patient who developed a first episode of Pisa syndrome (PS) to the right side and a second episode to the left side and to discuss the hypothesis that states that denervation is one of the main mechanisms implicated in the development of PS. METHODS: We report on the case of a 71-year-old patient with Parkinson disease who developed PS to the right side while on dopaminergic treatment with pramipexol and levodopa. The dopamine agonist was discontinued and the postural abnormality was corrected increasing the levodopa dose. Six years later, while on ropinirole and levodopa, he developed PS again but this time the lean was to the left. Even though the dopamine agonist was discontinued, this condition failed to improve. CONCLUSIONS: Mechanisms other than denervation and its relationship with the more or less affected side contribute to the development of the syndrome.This is the first report of a case of recurrent alternating PS and highlights the need for research on this topic to better understand this disorder.
Assuntos
Benzotiazóis/efeitos adversos , Agonistas de Dopamina/efeitos adversos , Distúrbios Distônicos/induzido quimicamente , Levodopa/efeitos adversos , Equilíbrio Postural , Transtornos de Sensação/induzido quimicamente , Idoso , Humanos , Masculino , Doença de Parkinson/tratamento farmacológico , PramipexolAssuntos
Antipsicóticos/efeitos adversos , Antagonistas de Dopamina/efeitos adversos , Distonia/induzido quimicamente , Distúrbios Distônicos/induzido quimicamente , Risperidona/efeitos adversos , Idoso , Distonia/diagnóstico , Distúrbios Distônicos/diagnóstico , Feminino , Humanos , Transtornos Psicóticos/tratamento farmacológicoRESUMO
Tardive dystonia (TDt) is a severe side effect of long-term use of antipsychotics. Previous publications suggested that TDt persist but the results are distorted by referral bias. In a population-based nine-year follow-up study (one baseline, six follow-ups) of chronic psychiatric patients (N=194) on a Caribbean island, the course of prevalent and incident TDt was measured with the Fahn-Marsden rating scale. Of the 26 patients (mean age 53.3 yrs) with TDt at baseline, 64% recovered, 20% persisted, and in 16% the course was intermittent. The severity of baseline TDt was significantly higher in persistent cases versus those who recovered (t=3.01, P<0.008). Of the 27 incident cases (cumulative 9-year incidence: 16.1%; mean age 57.6 yrs), 80% recovered, 8% persisted, and in 12% the course was intermittent. Predominantly affected were hands, eyes (blepharospasm), neck and mouth. The natural course of TDt is better than previously suggested but severe cases tend to persist.