Pisa syndrome as a motor complication of Parkinson's disease

Abstract

We describe two elderly patients with a convincing clinical diagnosis of Parkinson's disease (PD) who developed axial end-of-dose/off dystonia, also referred to as Pisa syndrome (PS). The worsening of symptoms in the “off” period, and a favorable response of the dystonia to an increase of levodopa suggests that PS in our patients may be primarily related to a manifestation of motor fluctuations in PD.