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1、Zenmyoetal.DiagnosticPathology2011,6:9http://www.diagnosticpathology.org/content/6/1/9CASEREPORTOpenAccessDroppedheadsyndromeduetomyogenicatrophy—acasereportofsurgicaltreatment*MichihisaZenmyo,MasahikoAbematsu,TakuyaYamamoto,YasuhiroIshidou,SetsuroKom
2、iya,KoseiIjiriAbstractWereportacaseofa69-year-oldmanwithdroppedheadsyndromeassociatedwithisolatedneckextensormyopathy(INEM).Overaperiodof2years,heexhibitedprogressiveinabilitytolifthischinoffhischest,resultinginthedroppedheadpositionthatimpairedhisact
3、ivitiesofdailyliving.Hehadadisturbedgaitwithsevereimbalanceofspinalalignment.Computedtomographyrevealedosseouscontractureofcervicalvertebralbodiesinflexedposition.Anteriorcombinedposteriorreconstructionsurgeryyieldedasuccessfuloutcomeinhisactivitiesof
4、dailyliving,includinghiswalkingbalanceofspinalalignment.Pathologicstudyconfirmedmyogenicatrophyinthecervicalextensormuscles.WesuggestthatconsiderationforsurgicalmanagementshouldbegiventodroppedheadsyndromeespeciallyduetoINEM.Backgroundwithoutneurologi
5、calabnormalitiessuchasmotorweak-Droppedheadsyndrome(DHS)ischaracterizedbynessorsensorydisturbance.Hehadnofamilyhistoryofsevereparavertebralextensormuscleweakness,resultingDHS.Nosystemicriskfactors,suchasdiabetes,vascularinchin-on-chestdeformity[1].Var
6、iousconditionsasso-disorders,historyofsmoking,werereported.HewasciatedwithDHShavebeenreported,includingneuro-workingasanofficeworkerfor25years,withoutpoten-musculardiseases,e.g.myastheniagravis,motorneurontialprofessionalhazardforDHS.Aplainradiographd
7、isease,congenitalmyopathy,chronicinflammatoryrevealedcervicaldegenerativekyphoscoliosiswithossifi-demyelinatingpolyneuropathy,andmitochondriopathycationoftheanteriorlongitudinalligament(Figure1).[2].SomeoftheseconditionsthatpresentwithDHSareElectrodia
8、gnosticstudydemonstratedpolyphasicmotorprogressiveandsystemic,andhaveagraveprognosis,unitpotentials(MUP)butnofibrillationpotentialsinsuchasamyotrophiclateralsclerosis[3].Othershaveathetrapeziusmuscle.Boththeamplitudeanddurationbenignclinicalco
