Dropped Head Syndrome: Rare Manifestation of Myasthenia Gravis

Abstract

Myasthenia gravis is an autoimmune disease of the neuromuscular junction that is characterized by muscle weakness and fatigue. Dropped head syndrome is a rare complication of myasthenia gravis and is manifested by a head drop resulting from progressive weakness of the flexor and extensor muscles of the neck. Targeted treatment of myasthenia gravis is associated with a recovery of neck strength, thus reducing the negative impact on daily life caused by this disease. It is essential that all healthcare professionals recognize the association between these two entities. We present the clinical case of a 68-year-old female initially evaluated in primary health care for head drop. The diagnosis of myasthenia gravis was only made one month after the initial appointment when other symptoms such as hypophonia and dysphagia were already present. Treatment with intravenous immunoglobulin allowed the recovery of strength in the extensor muscles of the neck.