Teaching Video Neuro <i>Images:</i> Lithium-induced reversible Pisa syndrome
Bibliographic record
Abstract
A 49-year-old man on chronic lithium therapy (1,500 mg/d) for bipolar disorder presented with a 2-year history of progressive left-lateral truncal flexion dystonia disappearing on lying supine (video 1 at [Neurology.org][1]), known as Pisa syndrome (PS), along with anterocollis and parkinsonism. Lithium serum level was normal (1.1 mmol/L). PS improved substantially 3 months after stopping lithium (video 2), supporting the diagnosis of lithium-induced PS (figure). PS has been reported with chronic use of a single or a combination of antipsychotics, but never with lithium monotherapy.1,2 Parkinsonism and PS may result from lithium-induced dopamine reuptake facilitation or dopamine receptor sensitivity reduction.2 [1]: http://neurology.org/lookup/doi/10.1212/WNL.0000000000003892
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".