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

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.