Reactions 1497, p35 - 19 Apr 2014

Ropinirole

Pisa syndrome: case reportA woman in her sixties [age at onset not clearly stated]

developed Pisa syndrome (PS) while receiving ropinirole forParkinson’s disease.

The woman presented at 68 years of age with a 4-yearhistory of right-hand clumsiness and markedly lateral flexedand stooped posture associated with gait difficulty. Thesymptoms began in 2009, and she had presented withhypomimia, bradykinesia and rigidity in February 2010. Shehad started receiving extended-release ropinirole 4 mg/day[route not stated]. Within 1 year, she had slowly developed aforward and left flexion of her trunk.

Levodopa was added to the woman’s treatment withimprovement of her Parkinson’s disease symptoms; however,her posture worsened slightly. She subsequently displayed amoderate bradykinesia and rigidity on the right side, withmarked forward and lateral flexion of her trunk. She was ableto lie down flat, but she immediately assumed a markedlyabnormal posture when she stood up. Her levodopa dosagewas increased with improvement of bradykinesia and rigidity;however, her posture deteriorated further. Ropinirole waswithdrawn, and 3 months later, her posture was nearlynormal.

Author comment: "The causative role even of the lowdosage of ropinirole is supported by the temporal relationshipbetween onset of PS and the introduction of therapy andparticularly by its dramatic amelioration after drugwithdrawal."Galati S, et al. Ropinirole-induced pisa syndrome in parkinson disease. ClinicalNeuropharmacology 37: 58-59, No. 2, Mar-Apr 2014. Available from: URL: http://doi.org/10.1097/WNF.0000000000000022 - Switzerland 803101794

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Reactions 19 Apr 2014 No. 14970114-9954/14/1497-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved