This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Neck extensor weakness resulting in dropped head is more often a part of a generalized neuromuscular disorder such as MG, ALS, or polymyositis. The term “dropped head syndrome” (isolated neck extension myopathy) usually refers to a condition characterized by severe weakness of the neck extensors in the absence of a generalized neuromuscular disorder and may be due to a restricted noninflammatory myopathy.1,2 ⇓ In such a case, there may, in fact, be additional weakness affecting periscapular, shoulder, and thoracic muscles or even more extensive distribution of weakness—“dropped head plus syndrome.”3 Hypothyroidism is often accompanied by a myopathy with proximal distribution.4 In 1880, William M. Ord described a woman with myxedema who had, among many other symptoms, head drop.5 There are, to our knowledge, no reports in the literature on isolated neck extensor weakness caused by hypothyroidism. We report a case of hypothyroidism presenting as an isolated dropped head syndrome, which subsided almost completely during treatment with levothyroxine.
Case report.
A 53-year-old man presented with a 4-year history of slowly progressive neck weakness and pain in the neck. He had “head drop” while sitting and standing and had noticed that his posterior neck muscles had increased in volume. For 6 months, he had also experienced a slight weakness in the arms and legs. His local neurologist had assessed the …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
