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Case Report
“Dropped head syndrome” in amyotrophic lateral sclerosis: A case report
1 Medical Student and Member of the Editorial Team of the Journal of Biological and Health Sciences of the Universidade Iguaçu, Nova Iguaçu, Rio de Janeiro, Brazil
2 Physician, Post-Doctorate in Health Sciences, Doctor in Neurology, Master in Collective Health, Professor and Coordinator of the Master's Degree Program in Neurology at the University of Vassouras and Adjunct Professor at the Medical School of the Iguaçu University, Rio de Janeiro, Brazil
3 Iguaçu University – UNIG – Hospital Geral de Nova Iguaçu, Rio de Janeiro, Brazil
Address correspondence to:
Antônio Marcos da Silva Catharino
Rua Gavião Peixoto 70, Room 811, CEP 24.2230-100, Icaraí, Niterói-RJ,
Brazil
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Article ID: 101274Z01JN2021
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How to cite this article
do Nascimento JF, Orsini M, Rodrigues ASP, Leitão RM, Nunes NSM, da Silva Catharino AM. “Dropped head syndrome” in amyotrophic lateral sclerosis: A case report. Int J Case Rep Images 2021;12:101274Z01JN2021.ABSTRACT
Introduction: The dropped head syndrome (DHS), also called slack head syndrome, was first detailed in 1986. This condition was recognized in 12 patients with various neuromuscular disorders, such as amyotrophic lateral sclerosis (ALS). It is characterized by asthenia of the extensor musculature of the neck, with or without asthenia of the flexor musculature of the neck, causing an inability to condition the head support and leading patients to the typical aspect of the flexed head with the chin in contact with the thoracic region.
Case Report: We report the case of a 68-year-old female who diagnosed with amyotrophic lateral sclerosis (ALS) about two years ago and reported limitations in her daily activities as the disease progressed. In her last visit, dated 03/30/2021, she presented great difficulty in sustaining her head in an anti-gravity position and, when asked to “bend” this region, she was unsuccessful in reerecting it. Need of concentration to maintain the cervical in neutral position and, after minutes, presented extreme fatigue with melting.
Conclusion: Despite being uncommon in ALS, the dropped head syndrome may occur in early or late stages and cause severe consequences to the individual, increasing his dependence and limiting his social interaction and quality of life. Given its numerous etiologies, patients with DHS without an established diagnosis should be investigated for the possible diagnosis of ALS. Measures are essential to prevent the installation of fixed deformities and the early designation of the best therapeutic approach for the patient becomes crucial.
Keywords: Amyotrophic lateral sclerosis, Electroneuromyography, Motor neuron
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Author Contributions
Jacqueline Fernandes do Nascimento - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Marco Orsini - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Angélica Sabino Pereira Rodrigues - Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Roberto Monteiro Leitão - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Nicolle dos Santos Moraes Nunes - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Antônio Marcos da Silva Catharino - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Jacqueline Fernandes do Nascimento et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
