Mantle Field Radiation for Hodgkin’s Lymphoma: An Effective Treatment, But at What Cost?

This retrospective case study investigates the clinical presentation of a 53-year-old female who underwent mantle field radiotherapy roughly 26 years ago. This patient presents with diffuse muscle atrophy and weakness in the cervical musculature, as well as sensory deficits in the upper extremities. We sought to compare our patient’s symptoms with other patients who had been formally diagnosed with Dropped Head Syndrome (DHS) by reviewing the existing literature. We found that the clinical presentation under investigation was consistent with other patients who had received radiotherapy for Hodgkins’s disease and were then diagnosed with DHS. Electromyography (EMG), nerve conduction studies, and a cervical MRI were unable to identify a separate neurological cause for the symptoms, but the MRI did confirm the presence of diffuse muscle atrophy in the cervical musculature. After reviewing the existing literature and imaging results, we compared our patient’s symptoms to those that define DHS, and both the time of onset, presenting symptoms, and progressing course are consistent with a diagnosis of Dropped Head Syndrome.