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Dropped-head syndrome due to steroid responsive focal myositis: a case report and review of the literature.
[focal myositis]
Isolated
severe
weakness
of
the
paraspinal
musculature
,
either
at
the
cervical
level
leading
to
a
"
dropped
head
syndrome
"
or
at
the
thoracic
level
leading
to
a
"
bent-spine
syndrome
"
,
is
a
rare
disorder
.
Etiologically
it
may
be
present
in
a
variety
of
neurological
diseases
including
Parkinson
's
disease
,
multiple
system
atrophy
,
neuromuscular
or
motor
neuron
diseases
,
as
well
as
non-
inflammatory
,
inflammatory
,
dystrophic
or
metabolic
myopathies
.
We
present
a
previously
healthy
74
-
year
-old
man
with
a
2
-
month
history
of
progressive
difficulty
in
lifting
his
chin
off
his
chest
.
Magnetic
resonance
imaging
and
skeletal
muscle
biopsy
revealed
an
isolated
myositis
of
the
neck
extensor
and
trapezius
muscles
,
which
responded
well
to
steroid
therapy
.
This
case
and
other
rare
reports
obtained
from
a
systematic
review
of
the
literature
indicate
that
in
a
subgroup
of
patients
"
dropped
head
syndrome
"
or
"
bent
spine
syndrome
"
is
caused
by
a
myositis
,
which
emphasizes
the
necessity
to
obtain
a
MRI
examination
,
as
well
as
a
muscle
biopsy
to
diagnose
this
potentially
treatable
disease
.
Diseases
Validation
Diseases presenting
"progressive difficulty"
symptom
focal myositis
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