Grisel??s Syndrome A Review

Wetzel, F. Todd; Rocca, Henry La

doi:10.1097/00003086-198903000-00017

Cited by 82 publications

(77 citation statements)

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“…In type III closed reposition and immobilization in a halo brace for up to 12 weeks is necessary, type IV is primarily treated surgically with fusion of C1 Pat No.5 9 y/o girl after otoplast (protruding ears). Three days after surgery she complains about a wryneck with the chin tilted to the left and her head flexed to the right and C2 [9,12,[15][16][17]20]. After surgical stabilization, persistent neurological complications occur in up to 15 % of all patients [21].…”

Section: Discussionmentioning

confidence: 99%

A novel technique to treat Grisel’s syndrome: results of a simplified, therapeutical algorithm

Pilge

Holzapfel

Lampe

et al. 2013

International Orthopaedics (SICOT)

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Section: Discussionmentioning

confidence: 99%

A novel technique to treat Grisel’s syndrome: results of a simplified, therapeutical algorithm

Pilge

Holzapfel

Lampe

et al. 2013

International Orthopaedics (SICOT)

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“…According to this protocol: Conservative treatment for type I is a soft collar, for type II a rigid collar, and a halo-vest for type III lesions. For type IV lesions, they recommend surgical treatment [23].…”

Section: Discussionmentioning

confidence: 99%

Non-traumatic Atlanto-axial Rotatory Subluxation- Grisel’s Syndrome Case Report and Literature Review

Rami¹,

Dj²,

Sotirios³

et al. 2016

J Spine

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Study design: Case report of conservatively treated non-traumatic Atlanto-axial rotatory sublaxation.Objective: To report our case with this rare condition (non-traumatic Atlanto-axial rotatory subluxation-Grisel Syndrome) in a 9-year old girl presenting with torticollis and neck pain and literature review. Summary of background data:Atlanto-axial rotatory fixation or non-traumatic atlanto-axial subluxation which is usually secondary to an infection or an inflammation at the head and neck region is a rare subtype of subluxation in which a pathologic fixation of the atlas on the axis is present. It is most common in paediatric patients and it can be managed conservatively in the acute stage. In contrast, cases of chronic non-traumatic atlanto-axial rotatory subluxation are usually treated with operative reduction, according to literature data. Although high success rates have been achieved with operative reduction in chronic cases, a significant reduction in neck motion occurs due to the atlanto-axial fusion.Methods: A 9-year-old girl developed torticollis established longer than 10 weeks as a result of an upper respiratory tract infection. Computed tomography showed a type 1 rotatory subluxation of the Atlanto-axial joint according to the classification of Fielding and Hawkins. The patient was treated by manual reduction according to Jeszenszky (Jeszenszky transoral Citation Nr 22) under general anaesthesia and fluoroscopy control, and then a halo vest had been applied for 6 weeks. Results:We successfully treated this patient with chronic non-traumatic Atlanto-axial rotatory subluxation with manual reduction and immobilisation by applying a halo-body-jacket. She showed full recovery of neck motion and normal Atlanto-axial angle on clinical and radiological follow-up after 1 month and 3 months respectively. Conclusion:Chronic non-traumatic Atlanto-axial rotatory subluxation is a rare condition which can easily escape the attention of physicians especially in children. Conservative treatment with complete reduction under anaesthesia and subsequent immobilisation via halo-body-jacket for at least 6 weeks is a viable option as presented in this case report. Surgical treatment should be reserved only for cases of failure of conservative management (recurrence or irreducible subluxation).

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“…9) Three main theories have been proposed to explain the pathogenesis of subluxation in Grisel's syndrome: Metastatic inflammatory effusion causes ligamentous stretching and subluxation; irritative contracture of the suboccipital and paravertebral muscles following cervical lymphadenitis due to nasopharyngeal infection leads to subluxation; and regional hyperemia leads to decalcification of the attachment of the transverse ligament, which causes ligamentous laxity and subluxation. 8) However, a previous case suggested that spasm of irritated neck muscles with distension in the ligaments causes torticollis and results in subluxation. 7) Therefore, the pathogenesis still remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…2) A new type of subluxation has been defined in patients with complaints of persistent torticollis without radiologic abnormality of the atlanto-axial joint. 3) Atlanto-axial subluxation after infection of the upper respiratory tract is now designated as Grisel's syndrome, 8) but was first described in 1830, 1) and variously known as malum suboccipitale rheumaticum, distension luxation, Drehungsverrenkung, torticollis nasopharyngien, maladie de Grisel, non-traumatic subluxation, spontaneous hyperemic dislocation, inflammatory dislocation, dislocation nontraumatique, and le faux torticollis aigu. Grisel's syndrome manifests as painful head tilt (Cook-Robin look), Sudek's sign, and restricted neck movements due to torticollis.…”

Section: Introductionmentioning

confidence: 99%

Non-traumatic Atlanto-axial Subluxation: Grisel's Syndrome -Two Case Reports-

Çekinmez

Tufan

Şen

et al. 2009

Neurol. Med. Chir.(Tokyo)

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Two 8-year-old boys presented with complaints of torticollis and pain on neck turning. Both patients had a history of throat infection. Radiography and computed tomography demonstrated atlanto-axial subluxation. The patients were treated under diagnoses of Grisel's syndrome, unilateral or bilateral subluxation of the atlas on the axis associated with infection in the head or neck. Both patients were treated conservatively with bed rest, muscle relaxants, non-steroid anti-inflammatory agents, and immobilization with a soft cervical collar and cervical halter traction. The torticollis had resolved and reduction of atlanto-axial subluxation was confirmed within 2 weeks in both patients. Early diagnosis of Grisel's syndrome with appropriate antibiotics and a cervical collar, with halter traction if necessary, can achieve good outcome. Surgical treatment for the reduction of atlanto-axial subluxation should be reserved for persistent or recurrent cases.

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Grisel??s Syndrome A Review

Cited by 82 publications

References 0 publications

A novel technique to treat Grisel’s syndrome: results of a simplified, therapeutical algorithm

A novel technique to treat Grisel’s syndrome: results of a simplified, therapeutical algorithm

Non-traumatic Atlanto-axial Rotatory Subluxation- Grisel’s Syndrome Case Report and Literature Review

Non-traumatic Atlanto-axial Subluxation: Grisel's Syndrome -Two Case Reports-

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