Article Text

Download PDFPDF
Late onset of dropped head syndrome following mantle radiation therapy for Hodgkin lymphoma
  1. Vincenzo Di Stefano1,
  2. Carmine Attanasi2,
  3. Camilla Ferrante1 and
  4. Antonio Di Muzio3
  1. 1 Department of Neuroscience, Imaging and Clinical sciences, "G. d’ Annunzio" University, Chieti, Italy
  2. 2 Centro regionale Sant’Alessio - "Margherita di Savoia per i ciechi", Roma, Italy
  3. 3 Department of Neurology, "SS Annunziata" hospital, Chieti, Italy
  1. Correspondence to Dr Vincenzo Di Stefano, vincenzo19689{at}


Dropped head syndrome (DHS) is a rare condition, characterised by weakness of the cervical paraspinal muscles with sagging of the head. It is usually seen in association with neurological disorders and rarely can follow radiotherapy. We report a case of a 54-year-old man survivor of Hodgkin lymphoma (HL), who developed DHS 28 years after radiotherapy. He was referred to our department due to progressive weakness and atrophy of cervical paraspinal and shoulder girdle musculature. Physical and neurophysiological examination, electromyography and MRI confirmed the diagnosis of DHS. In the following years, there was no progression of symptoms.

  • haematology (incl blood transfusion)
  • neuromuscular disease
  • spinal cord
  • radiotherapy
  • physiotherapy (rehabilitation)

Statistics from


  • Patient consent for publication Obtained.

  • Contributors VDS, CF and ADM provided clinical care to the patient, conception and design, acquisition of the data, analysis and interpretation of the data; CA and ADM revised the article critically for intellectual content; all authors contributed to and have approved the final version 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.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.