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Case Report

Open Access Gateway

Reversible Valproate Induced Pisa Syndrome and Parkinsonism in a Neuro-Oncology Patient with Depression and Epilepsy

Botturi A.a,b · Silvani A.a · Pravettoni G.d,e · Paoli R.A.b · Lucchiari C.c

Author affiliations

aDepartment of Neuro-Oncology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
bDepartment of Psychiatry, Università degli Studi di Milano, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
cDepartment of Philosophy, Università degli Studi di Milano, Milan, Italy
dDepartment of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
eApplied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy

Corresponding Author

Andrea Botturi

Via Celoria 11

IT–20133 Milan (Italy)


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Case Rep Neurol 2016;8:115–119

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Neurological and psychiatric conditions frequently overlap in neuro-oncology. This overlapping negatively affects patients’ quality of life and decreases the ability of providers to manage specific symptoms by therapy modulation, especially when psychopharmacotherapy needs to be prescribed. We describe here a patient with recurrent brain tumor, symptomatic epilepsy and depression who developed Pisa syndrome and parkinsonism after several months of valproic acid use. An accurate recognition of symptoms and treatment side effect allowed an appropriate clinical approach so as to rapidly improve both movement disorder and depression without increasing the risk of developing seizure. This has improved the autonomy and quality of life in a patient with poor prognosis.

© 2016 The Author(s). Published by S. Karger AG, Basel


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Article / Publication Details

Received: January 27, 2016
Accepted: May 09, 2016
Published online: June 06, 2016
Issue release date: May – August

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 1

eISSN: 1662-680X (Online)

For additional information: https://www.karger.com/CRN

Open Access License / Drug Dosage / Disclaimer

This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.