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Images in Neurology
February 2018

Pisa Syndrome in a Child With Subacute Sclerosing Panencephalitis

Author Affiliations
  • 1Department of Neurology, Govind Ballabh Pant Postgraduate Institute of Medical Education and Research, New Delhi, India
JAMA Neurol. 2018;75(2):255-256. doi:10.1001/jamaneurol.2017.4092

An 8-year-old child presented with slowness in daily activities, abnormal behavior, irritability, forgetfulness, and jerky movement of trunk and extremities for 3 months, as well as a right-sided tilt while standing or walking for 10 days. There was no history of recent exposure to neuroleptic or cholinergic medications. He had a history of measles at the age of 3 years. On examination, he was conscious but mute and sometimes followed only simple commands. He had masked facies with a blink rate of 6 to 8 blinks per minute. He had lateral bending of the trunk toward the right side during standing or walking, which is consistent with a diagnosis of Pisa syndrome (Video, segment 1).

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