2008
DOI: 10.1097/cnd.0b013e3181629396
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Isolated Head Drop Triggered by Neck Surgery Following Concomitant Chemoradiotherapy

Abstract: Dropped head syndrome (DHS) is characterized by severe weakness of neck extension that occurs in isolation or association with a generalized neuromuscular disorder. Multietiologies may be responsible for DHS, including radiotherapy, which may cause a delayed form of DHS. However, DHS acutely triggered by neck surgery after chemoradiotherapy is rare. The author reports a case of acute onset of isolated DHS following selective neck dissection surgery after concomitant chemoradiotherapy for laryngeal cancer.

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Cited by 9 publications
(14 citation statements)
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“…We consider that the early-onset DHS differs from late-onset DHS. Recently, early-onset DHS has been reported (Case 4–9 in Table 3 ) [ 7 , 8 ]. In contrast to the findings of our study, neck extensor muscle atrophy was observed in the reported cases of early-onset DHS.…”
Section: Discussionmentioning
confidence: 99%
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“…We consider that the early-onset DHS differs from late-onset DHS. Recently, early-onset DHS has been reported (Case 4–9 in Table 3 ) [ 7 , 8 ]. In contrast to the findings of our study, neck extensor muscle atrophy was observed in the reported cases of early-onset DHS.…”
Section: Discussionmentioning
confidence: 99%
“…Dropped head syndrome (DHS) is caused by various neuromuscular disorders [ 1 8 ]. It is also a famous but rare complication of radiotherapy [ 6 ].…”
Section: Introductionmentioning
confidence: 99%
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“…Considering that it can often take years, if not decades, before potential new radiosensitizers arrive in the clinic, Zheng et al [175] hypothesized that present clinical protocols involving high-energy radiation and platinum (Pt) chemotherapeutic agents could be improved by considering the fundamental principles of energy disposition, including the results of LEE experiments. Their initial goal was to explain the superadditive effect occurring in tumor treatments, when cisplatin and radiation were administered in concomitance [176,177]. Zheng et al [175] found that, with cisplatin bound to DNA as in the cancer cells, damage to the molecule increases by factors varying from 1.3 for high-energy electrons to 4.4 at 10 eV.…”
Section: Transient Anions In Dna Bound To Platinum Chemotherapeutic Agentsmentioning
confidence: 99%
“…In each group, the EF corresponds to the damage when the GNP alone is bound to DNA or when the GNP has been coated with ligands 2.5 and 4 nm in lengths corresponding to GNP@C 11 H 23 or GNP@DTDTPA (i.e., dithiolated diethylenetriaminepentaacetic acid), respectively in the figure . As shown by Zheng et al, only one GNP per DNA molecule is on average necessary to increase DNA damage considerably [216]. Thus, as long as the nanoparticles reach the DNA of cancer cells, the amount to be administered to patients to obtain significant radiosensitization should be at most the same as that of the Pt-drugs routinely administered in chemotherapy [176,177]. In recent in vitro experiments, GNPs were targeted to the DNA in the cell nucleus by linking peptides to the gold surface [197,202].…”
Section: Both In Vitro and In Vivo Experimentsmentioning
confidence: 99%