Nontraumatic Subluxation of the Atlanto-Axial Joint as Rare Form of Aquired Torticollis

Pilge, Hakan; Prodinger, Peter Michael; Bürklein, Dominik; Holzapfel, Boris Michael; Lauen, J.

doi:10.1097/brs.0b013e3181fab0e4

Cited by 41 publications

(43 citation statements)

References 13 publications

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“…The syndrome has been described to occur even months after local infections [10,13]. If diagnosis is established within four weeks, manual reposition seems to be adequate [4,6]. In the case of delayed diagnosis, many authors recommend immobilization with halo fixation for 12 weeks [6,12,16,17].…”

Section: Discussionmentioning

confidence: 99%

“…One week after manual repositioning, the patient presented a recurrence of the torticollis without subluxation of C1/C2 [4]. Though we decided not to reposition the spine again, restitution could be achieved in this case with regular physiotherapy.…”

Section: Therapymentioning

confidence: 93%

“…In an extensive literature review it was found that nearly every case reported was associated with either an infection of the ear, nose or throat, or a surgical intervention [4][5][6]. In 48 % of these cases a local infection was reported, whereas in 31 % the symptoms occurred after adenotonsillectomy.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, instability increases from type I to IV and higher stages may require surgical interventions (Tables 1 and 2) [9,12,15,16]. Adjuvant antibiotic treatment is considered to be beneficial [4,5,10].…”

Section: Introductionmentioning

confidence: 99%

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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%

Section: Therapymentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Pilge

Holzapfel

Lampe

et al. 2013

International Orthopaedics (SICOT)

Self Cite

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“…Nearly a century later, Pierre Grisel [11] described three patients with pharyngitis and torticollis who also had dislocation of the C1-C2 joint. Ever since, the condition has been called Grisel's syndrome (GS), with numerous case reports showing a strong association between its occurrence and upper respiratory tract infections or surgical interventions in the head and neck region [8,22,26].…”

Section: Introductionmentioning

confidence: 99%

Grisel’s syndrome: a comprehensive review with focus on pathogenesis, natural history, and current treatment options

et al. 2012

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Introduction Grisel's syndrome (GS) is a rare otolaryngologic condition that involves rotatory subluxation of the atlantoaxial joint in the absence of trauma. Sir Charles Bell was the first to describe this condition in 1830. However, it was named after Pierre Grisel, a French ENT specialist who in 1930 described three such cases in children. Methods Using standard search engines, we reviewed the most recent literature regarding GS with special attention to its pathogenesis, natural history, and recent treatment options. Results Although defined over 80 years ago, the exact pathogenesis leading to GS is still not completely understood. Nevertheless, it occurs mainly as a complication of upper respiratory tract infections and/or surgical interventions in the head and neck. Most recent studies postulate that the spread of septic emboli from such infection nidus via the pharyngovertebral veins to the periodontoid vascular plexus could be the most likely cause. The diagnosis of GS is made by both clinical assessment as well as radiologic confirmation with either CT scan or MRI. Our review found out that most authors favor immobilization with a soft collar and antibiotics over surgical correction in the initial management of GS. Surgery is reserved for severe and refractory cases. Conclusion GS remains a rare, but potentially lethal children condition. Early diagnosis and treatment is crucial to its management and prognosis.

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Grisel's Syndrome in an Adult After Endoscopic Nasopharyngectomy

Chua

Tan

et al. 2019

Laryngoscope Investig Oto

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Background Grisel's syndrome is rare in adults, and is characterized by nontraumatic atlanto‐axial subluxation secondary to infection. Here, we report a case of Grisel's syndrome occurring after endoscopic nasopharyngectomy. Methods A 67‐year‐old man complained of fever and neck pain with reduced lateral rotation after an endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma. Flexion and extension X‐rays of the cervical spine demonstrated atlanto‐axial subluxation, and magnetic resonance imaging showed infective changes with cervical osteomyelitis. A diagnosis of Grisel's syndrome with cervical spine osteomyelitis was made. A later computed tomography (CT) scan demonstrated subluxation of C1 on C2, as well as the occipital‐C1 joint. Results The patient was treated with intravenous antibiotics and offered surgery for spinal stabilization, but declined. He remained well 15 months post‐op on a cervical collar with minimal pain and no neurologic deficits. Conclusion A high index of suspicion for Grisel's syndrome is suggested in patients who have neck pain with reduced range of motion postnasopharyngectomy, and imaging is useful in clinching the diagnosis. Level of Evidence 4

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Nontraumatic Subluxation of the Atlanto-Axial Joint as Rare Form of Aquired Torticollis

Abstract: At least in this case, our treatment led to shorter recovery and avoidance of halo fixation. Our new therapeutic approach to patients with Grisel's syndrome might lead to a shorter recovery.

Cited by 41 publications

References 13 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

Grisel’s syndrome: a comprehensive review with focus on pathogenesis, natural history, and current treatment options

Grisel's Syndrome in an Adult After Endoscopic Nasopharyngectomy

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