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Pleurothotonus, commonly known as Pisa syndrome, is a rare neurological disorder which occurs due to prolonged exposure to antipsychotic drugs (which may also be referred to as neuroleptics). It is characterized by dystonia, and abnormal and sustained involuntary muscle contraction. This may cause twisting or jerking movements of the body or a body part. Although Pisa syndrome develops most commonly in those undergoing long-term treatment with antipsychotics, it has been reported less frequently in patients receiving other medications, such as an acetylcholinesterase inhibitor. However, it has also been seen in those with other diseases causing neurodegeneration and in those who are not receiving any medication (idiopathic Pisa syndrome). The characteristic development of Pisa syndrome consists of two types of dystonia: acute dystonia and tardive dystonia (also known as tardive dyskinesia). The underlying pathology of drug-induced Pisa syndrome is very complex, and development may be due to an underlying dopaminergic-cholinergic imbalance, or serotonergic/noradrenergic dysfunction.〔Van Harten: Ned Tijdschr Geneeskd. 1997 Jul 26;141(30):1471-4〕〔Nishimura, K: Pisa Syndrome Resolved After Switching to Olanzapine. Journal of Neuropsychiatry and Clinical Neuroscience 2007; 19:202-203〕〔M. Amore, M. Cerisoli, S. Campanile, A. Campanile: Pisa Syndrome. Report of a Case. Italian Journal of Neurological Sciences 1988; 9:273-274.〕 ==Causes== Pisa syndrome is predominantly caused by a prolonged administration or an overly dosed administration of antipsychotic drugs. Although antipsychotic drugs are known to be the main drugs that are concerned with this syndrome, several other drugs are reported to have caused the syndrome as well. Certain antidepressants, psychoactive drugs, and antiemetics have also been found to cause Pisa syndrome in patients.〔Suzuki et al., 1997 T. Suzuki, H. Kurita, T. Hori, M. Sasaki, A. Baba and H. Shiraishi, et al. The Pisa syndrome (pleurothotonus) during antidepressant therapy. Biol Psychiatry, 41 (1997), pp. 234–236.〕 Drugs found to have caused Pisa Syndrome: * Atypical antipsychotic drugs- ex. clozapine, aripiprazole * Tricyclic antidepressants- ex. clomipramine * Psychoactive drugs * Antiemetic drugs * Cholinesterase inhibitors〔Cossu et al., 2004 G. Cossu, M. Melis, G. Melis, E. Maccioni, V. Putzu, O. Catte, PF. Putzu, Reversible Pisa syndrome (pleurothotonus) due to the cholinesterase inhibitor galantamine: case report. Department of Neuroscience, Oct;19(10):1243-4.〕 * Galantamine〔 Based on the drugs that caused Pisa syndrome, it has been implicated that the syndrome may be due to a dopaminergic-cholinergic imbalance or a serotonergic or noradrenergic dysfunction. For the development of Pisa syndrome that cannot be alleviated by anticholinergic drugs, it has been considered that asymmetric brain functions or neural transmission may be the underlying mechanism. How these drugs interact with the biochemistry of the brain to cause the syndrome is unknown and a topic of current research. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Pleurothotonus」の詳細全文を読む スポンサード リンク
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