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Case report
Dropped head syndrome as initial and predominant manifestation of inflammatory myopathy
  1. Trajche Ivanovski1,
  2. Pablo Dávila González2,
  3. Montse Olivé Plana3 and
  4. Francesc Miralles Morell4
  1. 1Neurology, Hospital Universitari Son Llatzer, Palma de Mallorca, Balearic Islands, Spain
  2. 2Neurology, Fundació Hospital de Manacor, Manacor, Balearic Islands, Spain
  3. 3Neuromuscular Pathology Unit, Neurology, Hospital Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
  4. 4Neurology, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain
  1. Correspondence to Trajche Ivanovski; taneski99{at}gmail.com

Abstract

Dropped head syndrome (DHS) is an uncommon clinical syndrome, which requires complex diagnostic evaluation. A variety of neuromuscular and neurodegenerative disease can produce weakness of head extensor muscles and consequently lead to head drop. Inflammatory myopathy has been described as a cause of DHS, however head drop has only exceptionally been reported as being the presenting symptom of this disorder. We describe an original case of DHS as an initial and predominant manifestation of inflammatory myopathy with histopathological features of polymyositis, with an excellent response to immunosuppressive treatment.

  • muscle disease
  • neuromuscular disease
  • musculoskeletal syndromes

https://doi.org/10.1136/bcr-2019-233385

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    Footnotes

    • Contributors TI is the principal author of the manuscript, responsible for the patient during hospitalisation and most part of editing. PDG was responsible for follow up and editing of 'case presentation'. MOP analysed the muscle biopsy, participated in editing of the hystopahological findings and discussion. FMM did the electrophysiological studies, performed muscle biopsy and was responsable for reviewing the work in progress and correction of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.