PT - JOURNAL ARTICLE AU - Waqar Waheed AU - James Brian Allison AU - John Dewitt AU - Sharon Hallman AU - Rup Tandan TI - Axial muscle weakness AID - 10.1136/practneurol-2020-002736 DP - 2021 Apr 01 TA - Practical Neurology PG - 92--100 VI - 21 IP - 2 4099 - http://pn.bmj.com/content/21/2/92.short 4100 - http://pn.bmj.com/content/21/2/92.full SO - Pract Neurol2021 Apr 01; 21 AB - 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.