Dropped head syndrome and bent spine syndrome: two separate clinical entities or different manifestations of axial myopathy?

Four elderly women are reported on with myopathies manifesting with isolated or predominant involvement of the paraspinal musculature. In three, the neck extensors were affected foremost, leading to "dropped head syndrome". In one, weakness of the thoracic paraspinal muscles caused "bent spine syndrome". It is suggested that these clinically distinct syndromes are caused by a primary tardive myopathic condition predominantly affecting the entire axial musculature.