title: Dropped head sign as the only symptom of myasthenia gravis.
abstract: Neck extensor muscle weakness and the dropped head sign are associated with various neuromuscular disorders. However, these symptoms are comparatively rare in myasthenia gravis (MG). We report a MG case that presented with dropped head sign as the main symptom. A 55-year-old man developed subacute weakness of the neck extensor muscle and presented with dropped head. We established a diagnosis of MG based on the results of an edrophonium test and a voluntary single fiber electromyogram (vSFEMG), and a high serum antiacetylcholine receptor antibody level. This patient was treated with pyridostigmine and his neurological symptoms improved. There are reported cases of dropped head sign as the first symptom of MG, however, in those cases, other muscles showed weakness during the first few months after onset. In the present case, throughout the clinical course no other symptoms outside of dropped head sign were seen.
authors.affiliation: Neurology, Kushiro Rousai Hospital. yaguchi@xa2.so-net.ne.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yaguchi
authors.forename: Asako
authors.initials: A
authors.lastname: Takei
authors.forename: Sanae
authors.initials: S
authors.lastname: Honma
authors.forename: Isao
authors.initials: I
authors.lastname: Yamashita
authors.forename: Shizuki
authors.initials: S
authors.lastname: Doi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hamada
mesh_terms: D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D004491:Edrophonium; D004576:Electromyography; D006257:Head / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D009157:Myasthenia Gravis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011187:Posture / Q000502:physiology*; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D011788:Quality of Life
chemical_list: D002800:Cholinesterase Inhibitors; D004491:Edrophonium; D011729:Pyridostigmine Bromide