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South Med J. 2006 Aug;99(8):888-91.

Progressive cervical kyphosis associated with botulinum toxin injection.

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  • 1Department of Orthopedic Surgery, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 708, Charleston, SC 29425, USA.


Weakness of the neck extensors can lead to "dropped head syndrome", a condition of progressive cervical kyphosis in which a patient is unable to hold their head up against the force of gravity. This condition can be associated with structural abnormalities of the spine as found in ankylosing spondylitis and vertebral fractures. Neuromuscular disorders, such as myasthenia gravis, muscular dystrophies, inflammatory myopathies, and motor neuron disorders such as amyotrophic lateral sclerosis (ALS) have also been reported as etiologies of dropped head syndrome. In this article, we describe an elderly woman with rapidly progressive cervical kyphosis following an injection of botulinum toxin A into her neck extensor musculature.

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