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Axial muscle weakness
  1. Waqar Waheed1,
  2. James Brian Allison2,
  3. John Dewitt3,
  4. Sharon Hallman4,
  5. Rup Tandan1
  1. 1 Neurology, University of Vermont Medical Center, Burlington, Vermont, USA
  2. 2 Radiology, University of Vermont Medical Center, Burlington, Vermont, USA
  3. 3 Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, Vermont, USA
  4. 4 Physical Therapy, University of Vermont Medical Center, Burlington, Vermont, USA
  1. Correspondence to Waqar Waheed, 89 South Williams Street, Burlington, VT 05401, USA; waqar.waheed{at}


Axial myopathy is a rare neuromuscular disorder characterised by selective involvement of the paraspinal muscles, and presenting either as a bent spine and/or dropped head syndrome. The axial muscles can be involved in various conditions, including neuromuscular disease, movement disorders, spinal disease and metabolic disorders. There have been recent descriptions of disorders with selective axial muscle involvement, but overall axial myopathy remains under-recognised. Here, we review disorders of axial muscle function, provide guidance on interpreting axial muscles imaging and suggest a diagnostic algorithm to evaluate patients with axial muscles weakness.

  • Myopathy
  • Anatomy
  • MR
  • Neuromuscular
  • Pathology

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  • Correction notice This article has been corrected since it appeared Online First. Text has been corrected from Corticoteroids to Corticosteroids.

  • Contributors WW responsible for conceptualization, data collection, manuscript drafting; JA responsible for data collection, neuroradiology and manuscript editing; JD responsible for data collection, neuropathology and manuscript editing; SH responsible for clinical assessment (online video) as well as manuscript editing; RT responsible for critical review and manuscript editing.

  • Funding The authors declare that no funding was provided for this review from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Required BMJ consent forms for patients and volunteers were obtained for their participation in the creation of the supplemental video file.

  • Ethics approval Not required, submission is for a review not for a research article.

  • Provenance and peer review Not commissioned. Externally peer-reviewed by Jon Walters, Swansea, UK.

  • Data availability statement Not applicable, no data as submission is for review article.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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