1. [Dropped Head Syndrome after whiplash injury in a patient treated for a Hodgkin's lymphoma by mantle field radiotherapy].
- Author
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Schlienger M, Ferroir JP, Huguet F, Deluen F, Pène F, Marseguerra R, and Touboul E
- Subjects
- Accidents, Traffic, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Bleomycin administration & dosage, Cervical Plexus injuries, Cervical Plexus physiopathology, Cervical Vertebrae, Combined Modality Therapy, Dacarbazine administration & dosage, Dose Fractionation, Radiation, Doxorubicin administration & dosage, Electromyography, Hodgkin Disease complications, Hodgkin Disease drug therapy, Humans, Magnetic Resonance Imaging, Male, Mechlorethamine administration & dosage, Middle Aged, Muscle Weakness physiopathology, Neck Muscles physiopathology, Osteoarthritis complications, Prednisone administration & dosage, Procarbazine administration & dosage, Radiation Injuries physiopathology, Radiotherapy Dosage, Remission Induction, Vinblastine administration & dosage, Vincristine administration & dosage, Cervical Plexus radiation effects, Hodgkin Disease radiotherapy, Muscle Weakness etiology, Neck Muscles innervation, Radiation Injuries etiology, Radiotherapy, High-Energy adverse effects, Whiplash Injuries complications
- Abstract
The authors report a case of Dropped Head Syndrome with an unusually rapid onset after an accident in a patient with a history of Hodgkin's lymphoma cured by chemotherapy and mantle field radiotherapy and compare this case to the rare published cases of chronic Dropped Head Syndrome occurring after this type of treatment. A 56-year-old man was treated at the age 36 years for supra-diaphragmatic Hodgkin's lymphoma by chemotherapy and mantle field radiotherapy according to a standard technique and standard doses (40Gy, 20 fractions, 27 days). Seventeen years after the end of treatment, he experienced a violent whiplash injury, rapidly followed by a Dropped Head Syndrome, similar to the cases of chronic Dropped Head Syndrome already described in the context of Hodgkin's lymphoma (permanent flexion of the head, only reduced in the supine position). Physical and neurophysiological examination, electromyogram, and magnetic resonance imaging confirmed the diagnosis of Dropped Head Syndrome. Very few treatment options are available for the major disability related to Dropped Head Syndrome. This type of subacute onset of Dropped Head Syndrome has not been previously described. The good results of radiation therapy after chemotherapy allow a dose reduction to 30Gy in the involved regions. This, together with recent progress in treatment planning, should allow eradication of these complications., (Copyright © 2012. Published by Elsevier SAS.)
- Published
- 2013
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