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What Nonoperative Treatments Are Advisable For A 91-year-old With INEM Leading To DHS?

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Posted on Mon, 17 Apr 2023
Question: What nonoperative treatments are there for a 91-year-old patient with Isolated Neck Extension Myopathy (Dropped Head Syndrome)? This came on very suddenly.
doctor
Answered by Dr. Olsi Taka (5 hours later)
Brief Answer:
Physical therapy, main option.

Detailed Answer:

Hi,

Non operative options unfortunately are not many. Physical therapy is the only means which can slow down the progression. There has also been some suggested benefit of acupuncture, although being a part of alternative medicine, it's not well studied. However, these measures only slow down the progression, eventually surgery may become necessary.

Carrying a cervical collar is also an alternative, but only for a short term, if carried for long term it may contribute to muscle weakness.

Of course, these apply when isolated neck extension myopathy is the certain cause of DHS, it seems the diagnostic process is not finished since you've not even had an EMG. There are many possible causes to DHS which is why some tests are needed.

Hope I have answered your query. Let me know if I can assist you further.

Thank you.

Regards,
Dr. Olsi Taka
Neurologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (34 minutes later)
How is the EMG test administered?

On another topic, would a steroid shot in my knees help alleviate pain, and what type of doctor would give it to me?
doctor
Answered by Dr. Olsi Taka (13 minutes later)
Brief Answer:
Read below

Detailed Answer:

Hi,

EMG consists of two parts, electromyography and nerve conduction studies. Electromyography test consists in inserting tiny needles in the muscles which are to be studied and registering their electrical activity. The test is accompanied by nerve conduction studies as well, where electrodes are placed on the skin along the trajectory of a nerve and the velocity and strength of the signal traveling from one nerve point to the other is measured to assess nerve damage.

As for steroid injection, yes, that is often beneficial for arthritis. Different specialists, most commonly rheumatologists or orthopedicians, may apply it.

Hope I have answered your query.

Thank you.

Regards,
Dr. Olsi Taka
Neurologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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What Nonoperative Treatments Are Advisable For A 91-year-old With INEM Leading To DHS?

Brief Answer: Physical therapy, main option. Detailed Answer: Hi, Non operative options unfortunately are not many. Physical therapy is the only means which can slow down the progression. There has also been some suggested benefit of acupuncture, although being a part of alternative medicine, it's not well studied. However, these measures only slow down the progression, eventually surgery may become necessary. Carrying a cervical collar is also an alternative, but only for a short term, if carried for long term it may contribute to muscle weakness. Of course, these apply when isolated neck extension myopathy is the certain cause of DHS, it seems the diagnostic process is not finished since you've not even had an EMG. There are many possible causes to DHS which is why some tests are needed. Hope I have answered your query. Let me know if I can assist you further. Thank you. Regards, Dr. Olsi Taka Neurologist