A Case of Grisel Syndrome Showing No Underlying Laxity of the Atlanto-axial Joint.
10.5535/arm.2017.41.3.511
- Author:
Ah Reum AHN
1
;
Yul Hyun PARK
;
Eun Ji PARK
;
Shin Young YIM
Author Information
1. The Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea. syyim@ajou.ac.kr
- Publication Type:Case Report
- Keywords:
Atlanto-axial joint;
Torticollis;
Joint instability
- MeSH:
Atlanto-Axial Joint*;
Child;
Female;
Humans;
Joint Instability;
Ligaments;
Lymphadenitis;
Neck;
Torticollis
- From:Annals of Rehabilitation Medicine
2017;41(3):511-515
- CountryRepublic of Korea
- Language:English
-
Abstract:
Grisel syndrome is a rare, non-traumatic atlanto-axial subluxation associated with an inflammatory or infectious process in the upper neck. According to the two-hit hypothesis, which is widely accepted for the pathogenesis of Grisel syndrome, preexisting ligamentous laxity of the atlanto-axial joint is regarded as the first hit. An inflammatory or infectious process of the atlanto-axial joint acts as the second hit, resulting in non-traumatic atlanto-axial subluxation. We report on a 6-year-old girl with atlanto-axial subluxation following retropharyngeal and cervical lymphadenitis. She was diagnosed with Grisel syndrome, for which an initial computed tomography did not show any preexisting ligamentous laxity of the atlanto-axial joint. A literature review found only 4 case reports on Grisel syndrome with an initially normal atlanto-axial joint. The present case offers some evidence that a single hit, such as inflammatory changes in the atlanto-axial joint, might cause Grisel syndrome, even without underlying ligamentous laxity.
