Abstract
“Dropped Head Syndrome” is characterized by dropping of the head while in a sitting or standing position. This is a case study of seven middle-aged men and women with dropped head syndrome in which their clinical symptoms are discussed. Head dropping gradually progressed in these seven cases because of aggravation of a basic disease, drugs, neck muscle inflammation and neck muscle fatigue. After cessation of drugs and with bedrest and physical therapy, dropped head syndrome became a relatively benign condition with a non-progressive course. The causes of head ptosis were Parkinson's disease in three cases, cervical spondylosis deformation in two cases, one case of multiple system atrophy and one case of myotonic dystrophy. Because different causes were revealed for head drop, dropped head syndrome seems to be a heterogeneous condition. With regard to pathogenesis, our cases indicated weakness of the cervical muscles, muscle atrophy, hypotonicity of the cervical muscles and rigidity in the neck. The mechanism of dropped head is thought to be weakness and imbalance in the tonus of the paraspinal neck muscles. Dropped head syndrome may be due to weakness and atrophy of the posterior cervical muscles or hypertonicity of anterior cervical muscles. In addition, the term “axial myopathy” refers to a condition characterized by both head ptosis and camptocormia, which may occur as a result of similar pathophysiological processes affecting the paraspinal muscles of different parts of the spine.
