PMID: 17541227Jun 2, 2007Paper

Dropped head sign as the only symptom of myasthenia gravis

Internal Medicine
Hiroaki YaguchiTakeshi Hamada

Abstract

Neck extensor muscle weakness and the dropped head sign are associated with various neuromuscular disorders. However, these symptoms are comparatively rare in myasthenia gravis (MG). We report a MG case that presented with dropped head sign as the main symptom. A 55-year-old man developed subacute weakness of the neck extensor muscle and presented with dropped head. We established a diagnosis of MG based on the results of an edrophonium test and a voluntary single fiber electromyogram (vSFEMG), and a high serum antiacetylcholine receptor antibody level. This patient was treated with pyridostigmine and his neurological symptoms improved. There are reported cases of dropped head sign as the first symptom of MG, however, in those cases, other muscles showed weakness during the first few months after onset. In the present case, throughout the clinical course no other symptoms outside of dropped head sign were seen.

References

Jan 1, 1981·Annals of the New York Academy of Sciences·D GrobT Namba
Feb 3, 2004·Muscle & Nerve·Carmelo RodolicoMichele Gaeta
May 18, 2004·Neuromuscular Disorders : NMD·Michael PuruckherrThomas M Roy

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Citations

May 25, 2011·Muscle & Nerve·Miguel Chuquilin, Muhammad Al-Lozi
Mar 10, 2015·Neuromuscular Disorders : NMD·Michihiro TamaiTakeshi Nakano
Oct 21, 2016·Journal of the American Geriatrics Society·Yosuke AibaTsuyoshi Ogata
Dec 22, 2016·Muscle & Nerve·Marvin SihKourosh Rezania

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