title: Muscle restricted vasculitis causing dropped head syndrome:  a case report and review of the literature.
abstract: A 52-year-old man presented with a severe head drop and proximal extremity weakness. Magnetic resonance imaging of the cervical spine showed T2 hyperintensity in cervical paraspinal muscles. Electrodiagnostic studies revealed an axial myopathy isolated to paraspinal muscles. A splenius capitis muscle biopsy confirmed an acute myopathy associated with nonsystemic vasculitis. The patient improved on steroids, intravenous immunoglobulin, and monthly pulse doses of cyclophosphamide. Our case emphasizes that a subgroup of patients with dropped head syndrome have treatable conditions.
authors.affiliation: Department of Neurology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
authors.forename: Amy Almaraz
authors.initials: AA
authors.lastname: Nielsen
authors.forename: Benn E
authors.initials: BE
authors.lastname: Smith
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Engel
authors.forename: Erich Peter
authors.initials: EP
authors.lastname: Bosch
mesh_terms: D003520:Cyclophosphamide / Q000008:administration & dosage; D004576:Electromyography; D019416:Head Movements / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000188:drug therapy / Q000209:etiology*; D018908:Muscle Weakness / Q000150:complications; D009220:Myositis / Q000150:complications*; D009334:Neck Muscles / Q000473:pathology*; D009431:Neural Conduction / Q000502:physiology; D009460:Neurologic Examination; D010525:Peripheral Nerves / Q000503:physiopathology; D011241:Prednisone / Q000008:administration & dosage; D013577:Syndrome; D014657:Vasculitis / Q000150:complications*
chemical_list: D003520:Cyclophosphamide; D011241:Prednisone