Dropped Head Syndrome

Abstract

» Dropped head syndrome is a group of disorders with diverse etiologies involving different anatomical components of the neck, ultimately resulting in a debilitating, flexible, anterior curvature of the cervical spine.» Causes of dropped head syndrome include myasthenia gravis, amyotrophic lateral sclerosis, Parkinson disease, radiation therapy, and cumulative age-related changes. Idiopathic cases have also been reported.» Nonoperative treatment of dropped head syndrome includes orthotic bracing and physical therapy.» Surgical treatment of dropped head syndrome consists of cervical spine fusion to correct the deformity.» The limited data available examining the clinical and radiographic outcomes of surgical intervention indicate a higher rate of complications with the majority having favorable outcomes in the long term.

Dropped Head Syndrome Caused by Thoracolumbar Deformity

“…Treatment decisions are more complicated when patients with DHS also have thoracolumbar deformities. Although previous reports have described surgical treatment for chin-on-chest deformities with cervical corrective surgery, there have been no detailed reports on thoracolumbar corrective surgery for the treatment of DHS [10][11][12][13]17 . To the best of our knowledge, this study is the first case series of successful surgical treatment of DHS using thoracolumbar corrective surgery alone.…”

Dropped‐head syndrome in a dog secondary to myopathy of the cervical extensor muscles

“…2 DHS is characterised by weakness of the cervical extensor muscles, particularly the semispinalis cervicis muscles, resulting in an inability to elevate the head. 3,4 The condition can occur as an isolated clinical finding or as part of a generalised neuromuscular disorder. 5 DHS has been reported to occur secondary to a wide range of conditions, including myasthenia gravis, 6,7 polymyositis, 3,8 cervical myelopathies 9 and myopathies involving the neck extensor muscles.…”

“…3,4 The condition can occur as an isolated clinical finding or as part of a generalised neuromuscular disorder. 5 DHS has been reported to occur secondary to a wide range of conditions, including myasthenia gravis, 6,7 polymyositis, 3,8 cervical myelopathies 9 and myopathies involving the neck extensor muscles. [10][11][12] Reluctance to elevate the head due to cervical hyperaesthesia is a common presentation in dogs 13,14 ; however, cervical ventroflexion secondary to an inability to elevate the head is scarcely reported.…”

Prevalence of sarcopenia in idiopathic dropped head syndrome patients is similar to healthy volunteers

“…DHS is a rare condition in which weakness of the cervical extensor muscles causes horizontal gaze disorder, gait disturbance, and dysphagia 1 . While muscle atrophy also develops in neuromuscular and muscular disorders, idiopathic DHS caused by an unexplained cervical extensor weakness is a problem for many older patients 1 – 4 . With the aging of society, the prevalence of the disease may increase further.…”

“…With the aging of society, the prevalence of the disease may increase further. Although there are some reports on muscle degeneration in DHS, many aspects of the disease are still unknown 1 , 2 , 5 , 6 . Sarcopenia, an age-related loss of skeletal muscle and strength, is widely accepted as a geriatric disease that can exacerbate motor dysfunction and increase the risk of adverse consequences such as falls and disabilities in patients with DHS.…”