Late onset of dropped head syndrome following mantle radiation therapy for Hodgkin lymphoma

BMJ Case Rep. 2018 Dec 14;11(1):e226822. doi: 10.1136/bcr-2018-226822.

Abstract

Dropped head syndrome (DHS) is a rare condition, characterised by weakness of the cervical paraspinal muscles with sagging of the head. It is usually seen in association with neurological disorders and rarely can follow radiotherapy. We report a case of a 54-year-old man survivor of Hodgkin lymphoma (HL), who developed DHS 28 years after radiotherapy. He was referred to our department due to progressive weakness and atrophy of cervical paraspinal and shoulder girdle musculature. Physical and neurophysiological examination, electromyography and MRI confirmed the diagnosis of DHS. In the following years, there was no progression of symptoms.

Keywords: haematology (incl blood transfusion); neuromuscular disease; physiotherapy (rehabilitation); radiotherapy; spinal cord.

Publication types

  • Case Reports

MeSH terms

  • Brachial Plexus Neuropathies / etiology
  • Brachial Plexus Neuropathies / physiopathology*
  • Brachial Plexus Neuropathies / rehabilitation
  • Cancer Survivors
  • Exercise Therapy / methods*
  • Hodgkin Disease / radiotherapy*
  • Humans
  • Male
  • Middle Aged
  • Muscular Atrophy, Spinal / etiology
  • Muscular Atrophy, Spinal / physiopathology*
  • Muscular Atrophy, Spinal / rehabilitation
  • Neck Muscles / physiopathology
  • Neck Muscles / radiation effects*
  • Orthotic Devices
  • Radiotherapy / adverse effects*
  • Syndrome
  • Time Factors
  • Treatment Outcome