A case of isolated neck extensor myopathy responding favorably to immunotherapy

Area of Science:

• Neurology
• Pathology

Background:

• Dropped head syndrome presents a diagnostic challenge, often necessitating the exclusion of various neurological and muscular disorders.
• Isolated neck extensor myopathy is a rare condition that can manifest as dropped head syndrome.

Observation:

• A 79-year-old man presented with dropped head syndrome.
• Diagnostic workup excluded other potential causes, confirming isolated neck extensor myopathy.
• Neck extensor muscle biopsy revealed significant fibrosis but no evidence of myositis.

Findings:

• The patient received three cycles of corticosteroid treatment.
• A pronounced clinical improvement in dropped head syndrome symptoms was observed following corticosteroid therapy.

Implications:

• This case underscores the importance of considering isolated neck extensor myopathy in the differential diagnosis of dropped head syndrome.
• Corticosteroid therapy may be beneficial for dropped head syndrome attributed to isolated neck extensor myopathy, even in the absence of myositis.