A 59-year-old woman presented with pain and fatigability of neck extension evolved over three months. She soon developed slurring of speech and choking, especially in the evenings. Her examination showed weakness of the neck extensors and tongue atrophy with hyperreflexia.


CHALLENGE QUESTION

Dropped head syndrome is a recognized manifestation of all of the following except:
1. MuSK myasthenia gravis
2. Amyotrophic lateral sclerosis
3. Facioscapulohumeral muscular dystrophy
4. Polymyositis
5. Myotonia congenita

Watch the video and find the answer in the next edition of Practical Neurology® magazine.

Case selected from Dr. Shaibani's Video Atlas of Neuromuscular Diseases, available from Oxford University Press.

Aziz Shaibani, MD, FACP, FAAN, FANA is Director of Nerve Muscle Center of Texas. He is also Clinical Professor of Medicine at Baylor College of Medicine in Houston and is an Adjunct Professor of Neurology at Kansas University Medical Center in Kansas City, KS.