Radiation-induced camptocormia and dropped head syndrome

Seidel, Clemens; Kuhnt, Thomas; Kortmann, Rolf‐Dieter; Hering, Kathrin

doi:10.1007/s00066-015-0857-8

Cited by 19 publications

(3 citation statements)

References 20 publications

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“…However, the reported data were not stratified for cured patients and could not, therefore, be analyzed for the aim of our systematic review. Concerning radiotherapy-induced neurological toxicity, two reviews [ 55 , 56 ] and one retrospective cohort study [ 57 ] collected case reports of late-onset PN, camptocormia, or “dropped head syndrome”. These three reports investigated cHL patients treated with large irradiation fields (extended, mantle, or total nodal irradiation) and higher radiotherapy doses.…”

Section: Discussionmentioning

confidence: 99%

Late Neurological and Cognitive Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi

Franceschetti

Annunziata

Agostinelli

et al. 2021

Cancers

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Background: The continuously improving treatment outcome for classical Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL) over the last 25 years has led to a high number of long-term survivors. The impact of treatment, however, can sometimes be dramatic and long-lasting. Focusing on peripheral neuropathy (PN), cognitive impairment, fatigue, anxiety, and depression, researchers of the Fondazione Italiana Linfomi conducted a systematic review of the literature to collect the available data on sequelae incidence as well as evidence of follow-up strategies for long-term cHL and DLBCL survivors. Methods: The review was carried out under the methodological supervision of the Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy. The literature search was conducted on three databases (MEDLINE, Embase, and the Cochrane Library) updated to November 2019. The selection process and data extraction were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 2236 abstracts were screened, 247 full texts were analyzed, and 35 papers were included in the final analysis. Fatigue was the most extensively studied among neuropsychological sequelae, with a mean prevalence among cHL survivors of 10–43%. Although many of the papers showed an increased incidence of PN, cognitive impairment, and anxiety and depression in long-term cHL and DLBCL survivors, no definite conclusions can be drawn because of the methodological limitations of the analyzed studies. No data on monitoring and follow-up strategies of PN and other neuropsychological sequelae were highlighted. Conclusions: Based on our findings, future studies in this setting should include well-defined study populations and have a longitudinal trial design to assess the outcomes of interest over time, thus as to structure follow-up programs that can be translated into daily practice.

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Section: Discussionmentioning

confidence: 99%

Late Neurological and Cognitive Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi

Franceschetti

Annunziata

Agostinelli

et al. 2021

Cancers

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“…Radiation-induced DHS is a rare, delayed complication of high-dose mantle-field radiation therapy [6][7][8][9] ; therefore, >50 Gy to the neck extensor muscles is not recommended. 10 The diagnosis is challenging because of its late onset after irradiation and non-specific findings including muscle biopsy.…”

Section: Images In…mentioning

confidence: 99%

Dropped head syndrome due to chemoradiotherapy for nasal lymphoma, characterised by short tau inversion recovery high signal intensity in the cervical paraspinal muscles

et al. 2022

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“…In these diseases, camptocormia seem to be associated with a loss of function of paravertebral muscles. Fibrosis may be the reason for radiation-induced myopathies [58]. …”

Section: Pathophysiological Conceptsmentioning

confidence: 99%

Pathophysiological Concepts and Treatment of Camptocormia

Margraf

Wrede

Deuschl

et al. 2016

Journal of Parkinson’s Disease

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Camptocormia is a disabling pathological, non-fixed, forward bending of the trunk. The clinical definition using only the bending angle is insufficient; it should include the subjectively perceived inability to stand upright, occurrence of back pain, typical individual complaints, and need for walking aids and compensatory signs (e.g. back-swept wing sign). Due to the heterogeneous etiologies of camptocormia a broad diagnostic approach is necessary. Camptocormia is most frequently encountered in movement disorders (PD and dystonia) and muscles diseases (myositis and myopathy, mainly facio-scapulo-humeral muscular dystrophy (FSHD)). The main diagnostic aim is to discover the etiology by looking for signs of the underlying disease in the neurological examination, EMG, muscle MRI and possibly biopsy. PD and probably myositic camptocormia can be divided into an acute and a chronic stage according to the duration of camptocormia and the findings in the short time inversion recovery (STIR) and T1 sequences of paravertebral muscle MRI. There is no established treatment of camptocormia resulting from any etiology. Case series suggest that deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) is effective in the acute but not the chronic stage of PD camptocormia. In chronic stages with degenerated muscles, treatment options are limited to orthoses, walking aids, physiotherapy and pain therapy. In acute myositic camptocormia an escalation strategy with different immunosuppressive drugs is recommended. In dystonic camptocormia, as in dystonia in general, case reports have shown botulinum toxin and DBS of the globus pallidus internus (GPi-DBS) to be effective. Camptocormia in connection with primary myopathies should be treated according to the underlying illness.

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Radiation-induced camptocormia and dropped head syndrome

Cited by 19 publications

References 20 publications

Late Neurological and Cognitive Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi

Late Neurological and Cognitive Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi

Dropped head syndrome due to chemoradiotherapy for nasal lymphoma, characterised by short tau inversion recovery high signal intensity in the cervical paraspinal muscles

Pathophysiological Concepts and Treatment of Camptocormia

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