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Focal myopathy as a cause of anterocollis in Parkinsonism

We present a patient with levodopa‐responsive Parkinsonism who developed disproportionate anterocollis over a period of 4 to 5 weeks. A neurological evaluation, including EMG and muscle biopsy, demonstrated the presence of a focal myopathy typical of the so‐called “dropped head syndrome” or “isolated neck extensor myopathy.” Parkinsonian patients presenting with disproportionate anterocollis should be evaluated for focal myopathy, as this may represent one possible cause.