Reversible Valproate Induced Pisa Syndrome and Parkinsonism in a Neuro-Oncology Patient with Depression and EpilepsyBotturi A.a,b · Silvani A.a · Pravettoni G.d,e · Paoli R.A.b · Lucchiari C.c
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
Via Celoria 11
IT–20133 Milan (Italy)
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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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