To report PISA syndrome, a rare movement disorder, in a young patient of Subacute sclerosing panencephalitis (SSPE).

SSPE is a slowly progressive central nervous system disorder affecting children and young individuals caused by persistent mutant measles virus. Extra-pyramidal manifestations like tics, dystonia, parkinsonism, chorea and others have been described in literature in SSPE. We, here report PISA syndrome (reversible lateral bending of the trunk with a tendency to lean to one side) in a young male with SSPE.

A 23-year-old male presented in clinic with 2-year complaints of recurrent falls, decrease scholastic performance, personality changes, jerky movements of body, especially right upper limb. Since last 1 month patient also has right sided tilt of body in sitting and/or standing position, with tendency to fall on right side. Vaccination was incomplete in this patient but specific measles like eruptions in childhood were not there. No significant family history was present. On examination, patient had severe impairment in higher mental functions. Decreased blink rate and symmetrical bradykinesia was present but no tremors were evident. He was tilting towards right side on sitting, standing and walking, and had a tendency to fall on right side on standing suggesting PISA syndrome.