A Case of Dropped Head Syndrome Caused by Focal Myositis

doi:2018.20.1.29

J Electrodiagn Neuromuscul Dis > Volume 20(1); 2018 > Article

Case Report

J Korean Assoc EMG Electrodiagn Med 2018;20(1):29-32.
DOI: https://doi.org/10.18214/jkaem.2018.20.1.29 Published online June 30, 2018.

A Case of Dropped Head Syndrome Caused by Focal Myositis

Received: 31 October 2017 • Revised: 18 December 2017 • Accepted: 19 January 2018

Abstract

Dropped head syndrome is characterized by restricted weakness of the extensors of the neck. It can be caused by many neuromuscular disorders. We present a case of dropped head syndrome by focal myositis. A 73-year-old man had a difficulty in maintaining an erect posture of his neck and lifting his chin off the chest. These symptoms developed gradually over 11 months. The EMG of the bilateral cervical paraspinal muscles demonstrated fibrillation potentials and positive sharp waves. The MRI revealed a diffuse edema of the neck extensor muscles on T2-weighted images and gadolinium enhancement. The neck extensor weakness improved significantly after treatment of steroids. Dropped head syndrome is a rare condition and in a subgroup of patients it is caused by a focal myositis. The findings of EMG and MRI can give us make a diagnosis of focal myositis and be a rationale for use of steroids.

Key Words: dropped head syndrome, myositis