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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
"muscle biopsy"
symptom
cadasil
canavan disease
cohen syndrome
epidermolysis bullosa simplex
familial mediterranean fever
focal myositis
inclusion body myositis
neuralgic amyotrophy
pyomyositis
pyruvate dehydrogenase deficiency
sneddon syndrome
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