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- W1979069728 abstract "Background: Dropped head syndrome (DHS) can result from numerous neuromuscular disorders, but radiation therapy (RT) has been only recently suggested to be a further cause of this condition. We present two new cases, most probably resulting from cervical RT. Case report: Case 1: A 69-old woman presented with a 7-year progressive weakness of neck muscles resulting in DHS, preceded by neck pain during about 5 years. She had undergone mantle RT for Hodgkin disease when aged 38. Clinical examination revealed bilateral amyotrophy and deficit of paravertebral, supra- and infraspinatus, sternocleidomastoid and trapezius muscles. EMG revealed reduced amplitudes of motor unit potentials in trapezius and pseudomyotonic discharges in sternocleidomastoid muscles. Cervical CT-scan revealed fatty infiltration of paravertebral muscles. Case 2: A 67-year old man was referred for amyotrophic deficit of the neck extensors resulting in DHS, with a rapidly progressive onset 18 months earlier. Cervical RT had been administered when he was aged 62 for a recurrent laryngeal carcinoma, previously surgically treated. EMG revealed only neurogenic traces in the trapezius muscles. Cervical MRI disclosed fatty infiltration of neck muscles. In both cases, the search for other causes including motor neuron disease, myasthenia and myopathies remained negative. Discussion: Cervical RT has been recently reported as a cause of DHS. Though diagnostic certainty is difficult to reach, strong arguments plead for this origin in our cases, as the muscle topography was limited to muscles receiving their innervation from nerves or nerve roots included in the radiation portals, and no other causes were found during the workup. Furthermore, the delay of onset and absence of extension of the deficit during follow-up were compatible. The mechanism of the disease is still discussed. Conclusions: DHS can occasionally be due to cervical RT. Diagnosis requires a thorough assessment of alternative causes." @default.
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- W1979069728 date "2007-10-01" @default.
- W1979069728 modified "2023-09-26" @default.
- W1979069728 title "G.P.18.03 Radiation therapy: An unusual cause of dropped head syndrome" @default.
- W1979069728 doi "https://doi.org/10.1016/j.nmd.2007.06.430" @default.
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