Wikipedia Proposal: Pleurothotonus

Presented by Bhumi Patel, Sarang Choi, Kiara Offley

Main points

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General definition:

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  • Pleurothotonus, or commonly known as Pisa Syndrome, is a rare neurological reaction associated with prolonged exposure to antipsychotic drugs. It is characterized by dystonia, abnormal and sustained muscle contraction which may cause twisting or jerking movements of the body or a body part.

History

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  • Pleurothotonus was first discovered by Ekbom in the early 1970s. Cases of the syndrome were first observed in elderly female patients who were being treated with the antipsychotic drug named haloperidal.

Causes

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  • Side effect of prolonged antipsychotic therapy like neuroleptic treatments
  • Brought on by the introduction of or increase in a dopaminergic medication
  • Also has something to do with the role of serotonergic or noradrenergic mechanism
  • Can also be due to a motor complication of Parkinson's disease

Medications

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  • Haloperidol: A conventional antipsychotic drug. Prescribed to patients with a psychotic disorder, Tourette's disorder, or hyperactive children
  • Setraline: A antidepressant drug that is apart of the class called selective serotonin reuptake inhibitors or SSRIs. The drug is used to treat depression, panic attacks, obsessive compulsive disorder, social anxiety and post traumatic stress disorder.
  • Trazodone: A type of antidepressant drug called serotonin modulators. Used to treat depression by increasing the brain's natural serotonin levels to achieve mental stability.
  • Resperidones: A antipsychotic drug used to treat such diseases as schizophrenia, autistic disorder, and bipolar disorder

Symptoms

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  • Dystonic symptoms: tonic flexion of the trunk to one side and its slight rotation when sitting or standing. There is also an associated backward axial rotation of the spine.
  • Indifferent to markedly abnormal posture

Treatment

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  • There are two lines of treatment for Pleurothotonus. The first line entails discontinuation or reduction in dose of the antipsychotic drug(s). The second line of treatment is an anticholinergic medication.

References

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  1. Kurtz, et.al. (1993) Nervenarzt 64(11):742-6
  2. Nishimura, K: Pisa Syndrome Resolved After Switching to Olanzapine. Journal of Neuropsychiatry and Clinical Neuroscience 2007; 19:202-203
  3. Ziegenbein M, Schomerus G, Kropp S: Ziprasidone-induced Pisa syndrome after clozapine treatment. Journal Neuropsychiatry and Clinical Neuroscience 2003; 15:458–459
  4. Suzuki, et al. (1997) Biol Psychiatry 41:234-236
  5. M. Amore, M. Cerisoli, S. Campanile, A. Campanile: Pisa Syndrome. Report of a Case. Italian Journal of Neurological Sciences 1988; 9:273-274.

Division of Work

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The group will meet and work on the page together so a cohesive and comprehensive article can be written. Labor may be divided during this time if necessary.