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Case Reports
. 2020 Jun 21;12(6):e8735.
doi: 10.7759/cureus.8735.

Predominant Neck Extensor Muscle Weakness: A Rare Manifestation of Idiopathic Polymyositis

Hassan Kesserwani  1
Affiliations
Case Reports

Predominant Neck Extensor Muscle Weakness: A Rare Manifestation of Idiopathic Polymyositis

Hassan Kesserwani. Cureus. .

Abstract

Dropped head syndrome (DHS) is a rare disease. It can be an isolated phenomenon or secondary to an underlying inflammatory, genetic, or sporadic neuromuscular disease. Idiopathic polymyositis as an underlying cause of DHS is rare and this association has been described very few times in the literature. We describe a case of biopsy-proven polymyositis presenting with predominant neck extensor muscle weakness. This case report goes further into analyzing the biomechanics of neck extension and putative reasons for predilection of the neck extensor muscles with advancing age in patients with DHS who have underlying idiopathic polymyositis.

Keywords: cervical extensor muscles; head drop; idiopathic polymyositis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Head drop with atrophy of neck extensors
Figure 2
Figure 2. T2 weighted sagittal MRI of the cervical spine reveals moderately severe spondylosis but no kyphosis to explain head drop
Figure 3
Figure 3. Electromyogram recording of left biceps muscle showing short duration, small amplitude, polyphasic motor units with full interference pattern; sensitivity 500 microvolt and base 10 milliseconds
Figure 4
Figure 4. Hematoxylin and eosin stain of a longitudinal section demonstrating intense inflammatory invasion of a degenerated myocyte (arrow)
Figure 5
Figure 5. Hematoxylin and eosin stain demonstrating an axial section showing variation of muscle fiber size and central nuclei typical of a myopathy; an intense inflammatory invasion of a partially degenerated myocyte
See this image and copyright information in PMC

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