title: Dropped head syndrome preceding the onset of dementia with Lewy bodies.
abstract: A 67-year-old woman developed dropped head. Her neck was severely flexed, with prominent cervical paraspinal muscles, although no parkinsonism was observed. Brain MRI showed no significant findings. We considered dystonia as the cause of the dropped head and administered trihexyphenidyl, an anticholinergic. After 10 years of follow-up, remarkable psychotic symptoms, including hallucinations regarding insects, appeared. Following the discontinuation of trihexyphenidyl, the psychotic symptoms decreased but still remained. (123)I-N-isopropyl-p-iodoamphetamine single-photon emission computed tomography ((123)I-IMP SPECT) revealed hypoperfusion in the bilateral occipital lobes. We diagnosed the patient with dementia with Lewy bodies (DLB). This case suggests that dropped head syndrome may precede the onset of DLB.
authors.affiliation: Department of Neurology, Tenri Hospital, Japan.
authors.forename: Kanta
authors.initials: K
authors.lastname: Tanaka
authors.forename: Ikko
authors.initials: I
authors.lastname: Wada
authors.forename: Taro
authors.initials: T
authors.lastname: Okunomiya
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kambe
authors.forename: Akiyo
authors.initials: A
authors.lastname: Shinde
authors.forename: Takashi
authors.initials: T
authors.lastname: Kageyama
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Suenaga
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D020367:Iofetamine; D020961:Lewy Body Disease / Q000175:diagnosis* / Q000453:epidemiology*; D008279:Magnetic Resonance Imaging; D009468:Neuromuscular Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D011618:Psychotic Disorders / Q000453:epidemiology; D019275:Radiopharmaceuticals; D013577:Syndrome; D015899:Tomography, Emission-Computed, Single-Photon; D014282:Trihexyphenidyl / Q000627:therapeutic use
chemical_list: D018680:Cholinergic Antagonists; D019275:Radiopharmaceuticals; D014282:Trihexyphenidyl; D020367:Iofetamine