Dropped Head Syndrome

Condition characterized by sagging of the head due to severe NECK MUSCLES weakness in the back of the neck. It may result in severe cervical KYPHOSIS called chin-on-chest deformity. Dropped head syndrome is most often associated with other diseases, e.g., PARKINSON'S DISEASE; STROKES; HEAD AND NECK CANCER; and ANKYLOSING SPONDYLITIS.

Also Known As:

Chin on Chest Deformity; Chin-on-Chest Deformities; Deformity, Chin-on-Chest; Dropped Head Syndromes; Chin-on-Chest Deformity

Networked: 83 relevant articles (5 outcomes, 1 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Myositis (Idiopathic Inflammatory Myopathies)
2.	Parkinson Disease (Parkinson's Disease)
3.	Hodgkin Disease (Hodgkin's Disease)
4.	Cellulitis
5.	Neoplasm Metastasis (Metastasis)

Experts

1.	Koda, Masao: 5 articles (01/2020 - 03/2016)
2.	Yamazaki, Masashi: 4 articles (01/2020 - 03/2016)
3.	Matsuoka, Yuji: 3 articles (01/2020 - 11/2018)
4.	Murata, Kazuma: 3 articles (01/2020 - 11/2018)
5.	Nishimura, Hirosuke: 3 articles (01/2020 - 11/2018)
6.	Suzuki, Hidekazu: 3 articles (01/2020 - 11/2018)
7.	Takamatsu, Taichiro: 3 articles (01/2020 - 11/2018)
8.	Yamamoto, Kengo: 3 articles (01/2020 - 11/2018)
9.	Furuya, Takeo: 3 articles (02/2019 - 03/2016)
10.	Takahashi, Kazuhisa: 3 articles (02/2019 - 03/2016)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Dropped Head Syndrome:

1.	Dopamine Agonists (Dopamine Agonist)IBA 08/01/2006 - "In 2 patients, administration of a dopamine agonist appeared to evoke dropped head syndrome. " 09/01/2017 - "Reversal of Dropped Head Syndrome After the Cessation of Dopaminergic Agonist Treatment in Parkinson Disease." 09/01/2001 - "Cases involving dropped head syndrome due to Parkinson's disease are reportedly improved by L-dopa, but exasperated by dopamine agonists. "
2.	Serotonin (5 Hydroxytryptamine)IBA 08/01/2020 - "The potential efficacy of serotonin noradrenaline reuptake inhibitor duloxetine in dropped head syndrome: A case report and review of the literature."
3.	Norepinephrine (Noradrenaline)FDA LinkGeneric 08/01/2020 - "The potential efficacy of serotonin noradrenaline reuptake inhibitor duloxetine in dropped head syndrome: A case report and review of the literature."
4.	Levodopa (L Dopa)FDA LinkGeneric 09/01/2001 - "Cases involving dropped head syndrome due to Parkinson's disease are reportedly improved by L-dopa, but exasperated by dopamine agonists. "
5.	Anti-Bacterial Agents (Antibiotics)IBA 01/01/2021 - "We present a unique case of dropped head syndrome due to focal myositis that exacerbated following cellulitis and was dramatically improved along with the improvement of her cellulitis only treated with antibiotics. "
6.	Duloxetine Hydrochloride (Cymbalta)FDA Link 08/01/2020 - "The potential efficacy of serotonin noradrenaline reuptake inhibitor duloxetine in dropped head syndrome: A case report and review of the literature."
7.	Cisplatin (Platino)FDA LinkGeneric 08/01/2022 - "Dropped head syndrome (DHS) involves severe weakness of the neck extensor muscles causing the mandible to drop to the chest wall. Isolated neck extensor weakness is a rare complication of radiotherapy. This condition may result within a few weeks or months following radiotherapy (early-onset) or several years after radiotherapy (late-onset), with the latter more commonly encountered. Person-in-the-barrel syndrome is marked by bilateral brachial diplegia, intact cranial nerves, and preserved lower extremity strength. We describe the unique clinical profile of a patient with a six-week history of significant neck and bilateral upper extremity weakness who was diagnosed three months prior to the onset of these symptoms with moderately differentiated squamous cell carcinoma within the base of the tongue (Stage III T2N1M0) and metastasis to the cervical lymph nodes. She underwent concurrent chemotherapy with three cycles of cisplatin (197 mg {100 mg/m2} x 197 m2) and hyperfractionated external beam radiation therapy (total dose cGy 7000 cGy in 35 fractions {200 cGy per fraction}). She reported the rapid onset of neck and bilateral upper extremity weakness six weeks following cisplatin termination and four weeks after radiation termination. A cervical MRI suggested myositis of the cervical paraspinal muscles, and electrodiagnostic studies indicated an inflammatory myopathic process involving the cervical paraspinal and shoulder girdle muscles. The patient attained a complete resolution of her symptoms eight months after onset. This case illustrates the rare phenomenon of early-onset DHS and person-in-the-barrel syndrome caused by radiation-induced myositis. Prompt recognition of the symptoms associated with DHS and timely treatment offer the best prognosis for recovery."
8.	SteroidsIBA 10/01/2010 - "Steroid-responsive dropped-head-syndrome due to polymyositis." 04/15/2008 - "Dropped-head syndrome due to steroid responsive focal myositis: a case report and review of the literature." 06/01/1999 - "Focal, steroid responsive myositis causing dropped head syndrome." 04/01/2016 - "This is a unique child with paraneoplastic steroid-responsive encephalopathy and dropped head syndrome in association with neuroblastoma." 04/01/2016 - "Steroid-Responsive Encephalopathy, Dropped Head Syndrome, and Hypertension in a Toddler: Is There a Clue?"
9.	Mitogen-Activated Protein Kinase Kinases (MEKs)IBA 01/01/2018 - "On/off dropped head syndrome: A severe adverse event after prolonged treatment with MEK inhibitor." 10/30/2012 - "Dropped head syndrome: report of three cases during treatment with a MEK inhibitor." 01/01/2018 - "Dropped-head syndrome in a patient under treatment with the MEK inhibitor trametinib for NRAS-mutated metastatic melanoma."
10.	SolutionsIBA 01/01/2021 - "Occipitopexy as a Fusionless Solution for Dropped Head Syndrome: A Case Report." 11/14/2012 - "Especially for ambulatory patients with Dropped-head syndrome is the «head-up» a very good solution." 11/14/2012 - "[The head-up-orthosis - a good solution for ambulant patients with Dropped-head-syndrome]." 01/01/2008 - "The "baseball cap orthosis": a simple solution for dropped head syndrome."

Therapies and Procedures

1.	Radiotherapy 08/01/2022 - "Early-Onset Dropped Head Syndrome and Person-in-the-Barrel Syndrome After Radiation Therapy: Clinical, Electromyographic, and MRI Findings." 01/01/2016 - "Dropped Head Syndrome Following Mantle Radiation Therapy." 11/01/2012 - "Dropped head syndrome induced by radiotherapy is very rare. " 10/01/2008 - "Finally, the spectrum of late-delayed complications of irradiation further increases with a better clinical characterization of radiotherapy-induced dropped head syndrome. " 11/01/2006 - "This report adds to the increasing literature about the late neurological complications of radiation therapy and describes a previously unrecognized cause of dropped head syndrome."
2.	Drug Therapy (Chemotherapy) 02/01/2013 - "The authors report a case of Dropped Head Syndrome with an unusually rapid onset after an accident in a patient with a history of Hodgkin's lymphoma cured by chemotherapy and mantle field radiotherapy and compare this case to the rare published cases of chronic Dropped Head Syndrome occurring after this type of treatment. " 08/01/2022 - "Dropped head syndrome (DHS) involves severe weakness of the neck extensor muscles causing the mandible to drop to the chest wall. Isolated neck extensor weakness is a rare complication of radiotherapy. This condition may result within a few weeks or months following radiotherapy (early-onset) or several years after radiotherapy (late-onset), with the latter more commonly encountered. Person-in-the-barrel syndrome is marked by bilateral brachial diplegia, intact cranial nerves, and preserved lower extremity strength. We describe the unique clinical profile of a patient with a six-week history of significant neck and bilateral upper extremity weakness who was diagnosed three months prior to the onset of these symptoms with moderately differentiated squamous cell carcinoma within the base of the tongue (Stage III T2N1M0) and metastasis to the cervical lymph nodes. She underwent concurrent chemotherapy with three cycles of cisplatin (197 mg {100 mg/m2} x 197 m2) and hyperfractionated external beam radiation therapy (total dose cGy 7000 cGy in 35 fractions {200 cGy per fraction}). She reported the rapid onset of neck and bilateral upper extremity weakness six weeks following cisplatin termination and four weeks after radiation termination. A cervical MRI suggested myositis of the cervical paraspinal muscles, and electrodiagnostic studies indicated an inflammatory myopathic process involving the cervical paraspinal and shoulder girdle muscles. The patient attained a complete resolution of her symptoms eight months after onset. This case illustrates the rare phenomenon of early-onset DHS and person-in-the-barrel syndrome caused by radiation-induced myositis. Prompt recognition of the symptoms associated with DHS and timely treatment offer the best prognosis for recovery."
3.	Conservative Treatment 01/01/2020 - "The initial treatment of dropped head syndrome (DHS) is basically nonsurgical, but the mode of onset of DHS and efficacy of conservative treatment have not been fully clarified. " 01/01/2020 - "Mode of onset of dropped head syndrome and efficacy of conservative treatment." 10/01/2023 - "Previous reports on the outcome of conservative treatment for dropped head syndrome (DHS) are scarce. " 10/01/2023 - "Conservative treatment for dropped head syndrome."
4.	Osteotomy 08/01/2007 - "We present a technique for controlled extension osteotomy correction of chin-on-chest deformity in a prone position. " 12/01/2020 - "In the presence of chin-on-chest deformity of ankylosing spondylitis, positioning for extension osteotomy of the spine is a challenging endeavor. " 12/01/2020 - "An Innovative System to Facilitate Extension Osteotomy in the Prone Position for Chin-on-Chest Deformity of Ankylosing Spondylitis." 11/20/2020 - "Extension crosswise osteotomy at C7 (C7 ECO) was developed for the correction of forward gaze in patients with chin-on-chest deformity due to ankylosing spondylitis. " 11/20/2020 - "C7 extension crosswise osteotomy: a novel osteotomy for correction of chin-on-chest deformity in a patient with ankylosing spondylitis."
5.	Activities of Daily Living (ADL) 01/01/2020 - "DHS is characterized by chin-on-chest deformity and devastatingly impedes activities of daily living in affected individuals. " 11/01/2018 - "DHS is characterized by chin-on-chest deformity and devastatingly impedes activities of daily living in affected individuals. " 01/01/2018 - "Dropped head syndrome has various implications on a patient's quality of life and activities of daily living. " 03/01/2009 - "Dropped head syndrome (DHS) associated with parkinsonism is not frequent, but it markedly reduces the activities of daily living and is refractory. " 06/01/2018 - "Dropped head syndrome (DHS) is characterized by a chin-on-chest deformity, which can severely interfere with forward vision and impair activities of daily living. "