Bulbar symptoms and episodic aphonia associated with atlanto-occipital subluxation in ankylosing spondylitis

Abstract

SYNOPSIS A patient with intermittent aphonia associated with atlanto-occipital subluxation due to ankylosing spondylitis is presented and discussed. The only other case from the literature is reviewed and compared with our patient, where symptoms and signs of episodic low bulbar disease, presumably due to intermittent vascular insufficiency, were relieved by external bracing.

Exploration for reliable radiographic assessment method for hinge-like hypermobility at atlanto-occipital joint

“…O-C1 instability can be also associated with rheumatoid arthritis (RA) [16,20] ankylosing spondylitis (AS) [8,22], Down syndrome [3,11,23] or infectious diseases [26], as mentioned. Future study using the radiographic method we proposed in the current study may also contribute to clarify the underlying mechanism of these diseases.…”

“…Non-traumatic O-C1 instability [3,8,14,16,20,22,23,26], which is less common, is usually associated with rheumatoid arthritis (RA) [16,20] or ankylosing spondylitis (AS) [8,22]. It can also be associated with Down syndrome [3,11,23] or infectious diseases [26].…”

Hangman's fracture in ankylosing spondylitis preceded by vertical subluxation of the axis

“…HANGMAN'S FRACTURE IN ANKYLOSING SPONDYLITIS PRECEDED BY VERTICAL SUBLUXATION OF THE AXIS MURRAY BARON, CHARLES H. TATOR, and HUGH LITTLE Vertical subluxation of the axis is rare in ankylosing spondylitis (AS) and has been reported in only two previous cases (1,2). Forward subluxation of the atlas on the axis is the abnormality of the upper cervical spine which has been more commonly described (3)(4)(5).…”