Parkinsonism and dropped head: Dystonia, myopathy or both?

Rodolfo Savica, Neeraj Kumar, J. Eric Ahlskog, Keith Anthony Josephs, Joseph Y. Matsumoto, Andrew McKeon

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Dropped head syndrome (DHS) occurring with parkinsonism is often suggested to be a clue to multiple system atrophy (MSA), but it may occur in other parkinsonian conditions. The substrate for DHS is controversial, with some concluding that the cause is myopathic and others, exclusively dystonic. We report our clinical series of DHS arising in the setting of parkinsonism. Methods: Patients with DHS were initially identified by a retrospective computer search of the Mayo Clinic (Rochester, MN) medical record database from January 1997 to July 2010. Subsequent record review confirmed DHS and documented those with parkinsonism. Results: We identified 21 patients with DHS and parkinsonism, 12 male, 9, female. The median age of DHS onset was 69 years (interquartile range: 63.6-77.5 years). This included 10 patients with Parkinson's disease (PD), 10 with MSA, and 1 with drug-induced parkinsonism. The DHS component of their disorder segregated into three different subgroups: dystonia-alone (12 patients); myopathy-alone (4 patients; focal cervical myopathy in 3 and generalized myopathy in one); coexisting dystonia and myopathy (5 patients; 3 generalized, 2 focal cervical myopathy). Conclusions: DHS may be seen in either MSA or PD. It may be due to myopathy, dystonia or both. In some cases, the myopathy was focal, confined to the neck musculature. Whether dystonic antecollis predisposes to local muscle pathology is open to speculation.

Original languageEnglish (US)
Pages (from-to)30-34
Number of pages5
JournalParkinsonism and Related Disorders
Volume18
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Dystonia
Parkinsonian Disorders
Muscular Diseases
Head
Multiple System Atrophy
Medical Records
Parkinson Disease
Neck
Databases
Pathology
Muscles

Keywords

  • Antecollis
  • Camptocormia
  • Dropped head syndrome
  • Parkinsonism

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Clinical Neurology
  • Neurology

Cite this

Parkinsonism and dropped head : Dystonia, myopathy or both? / Savica, Rodolfo; Kumar, Neeraj; Ahlskog, J. Eric; Josephs, Keith Anthony; Matsumoto, Joseph Y.; McKeon, Andrew.

In: Parkinsonism and Related Disorders, Vol. 18, No. 1, 01.2012, p. 30-34.

Research output: Contribution to journalArticle

Savica, Rodolfo ; Kumar, Neeraj ; Ahlskog, J. Eric ; Josephs, Keith Anthony ; Matsumoto, Joseph Y. ; McKeon, Andrew. / Parkinsonism and dropped head : Dystonia, myopathy or both?. In: Parkinsonism and Related Disorders. 2012 ; Vol. 18, No. 1. pp. 30-34.
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