Rivastigmine-induced Pisa Syndrome

Rivastigmine引發之比薩症候群

王桓奇(Huan-Chi Wang) ； 邱瑞祥(Juz-Hsiang Chiu)

《台灣精神醫學》 22卷2期 (2008/06) Pp. 154-158

https://doi.org/10.29478/TJP.200806.0009

摘要

目的：報告一位使用rivastigmine引起比薩症候群(Pisa syndrome)的案例。病例報告：一位77歲使用rivastigmine治療失智症的男性個案，在每日劑量提升到9毫克時，觀察到不自主運動障礙－比薩症候群的發生。在rivastigmine的劑量調低後，比薩症候群隨之消退。結論：因為使用膽鹼酯酶抑制劑而引起的運動障礙已被廣泛討論，現有用以治療失智症的膽鹼酯酶抑制劑都有可能引起比薩症候群。本個案的運動障礙之消長主要與rivastigmine劑量相關，所以診斷為rivastigmine引發之比薩症候群。一旦停用膽鹼酯酶抑制劑後，大多數個案可以恢復。建議此類個案宜使用最低有效劑量並且密切監測運動障礙。

關鍵字

膽鹼酯•抑制劑 ； 比薩症候群 ； rivastigmine

並列摘要

Objective: We report a case of Pisa syndrome (pleurothotonus) after administration of rivastigmine. Case Report: A 77-year-old man with dementia was treated with rivastigmine. Once titration of the daily dose reached 9 mg, he developed Pisa syndrome, an involuntary movement disorder. Pisa syndrome subsided after reducing the rivastigmine dosage. Conclusion: Pisa Syndrome related to cholinesterase inhibitors has been well discussed. The currently available cholinesterase inhibitors for dementia treatment can induce Pisa syndrome. The emergence and resolution of Pisa syndrome in our patient correlated with the dose of rivastigmine. Most patients recover from Pisa syndrome once the cholinesterase inhibitors are discontinued. Administration of the minimally effective dose and close monitoring for movement disorders among patients on cholinesterase inhibitor therapy is recommended.

並列關鍵字

cholinesterase inhibitor ； Pisa syndrome ； rivastigmine

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