Isolated neck extensor myopathy associated with cervical spondylosis : a case report and brief review

Abstract

Dropped head syndrome (DHS) is manifested as the inability to maintain the head in an upright posture. It has been associated with a wide spectrum of myopathies and neurological conditions. Isolated neck extensor myopathy (INEM) is one of many potential causes of DHS. This is a case report of a 72-year-old man who presented with degenerative cervical spondylosis and DHS for 2 years. He had previously failed to achieve a positive outcome to medication, cervical collar and exercise rehabilitation. However, he was able to regain his voluntary head control after a 4-month chiropractic program. It is believed that INEM is caused by isolated myopathic changes from chronic injury and overloading of the cervical muscles. Cervical spondylosis has been attributed as the cause of DHS secondary to denervation of the cervical extensors. While INEM associated with degenerative spondylosis is not medically treatable, manipulative therapies may be adopted before considering surgical intervention.