Grisel’s syndrome

Refers to a non-traumatic subluxation of the atlanto-axial joint caused by inflammation of the adjacent tissues.

A rare disease that usually affects children.

Progressive throat and neck pain and neck stiffness and torticollis can be followed by neurologic symptoms such as pain or numbness radiating to arms.

In extreme cases, the condition can lead to quadriplegia and even death from acute respiratory failure.

Often follows soft tissue inflammation in the neck with upper respiratory tract infections, peritonsillar or retropharyngeal abscesses, and post-operative inflammation after adenoidectomy.

Can see this condition in susceptible individuals such as those with Down’s syndrome, have inherently lax ligaments.

Pathophysiology consists of relaxation of the transverse ligament of the atlanto-axial joint.

Diagnosis established using plain film x-rays as well as CT scan of the neck/cervical spine.

Treatment includes anti-inflammatory medications and immobilization of the neck, in addition to treatment of the infectious cause with appropriate antibiotics.

Early treatment is essential to prevent complications.

Surgical fusion may maybe required for residual instability of the joint.

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