Grisels syndrome is nontraumatic subluxation of the atlantoaxial joint thought to be caused by inflammation of adjacent tissue, which relaxes the transverse ligament of the atlantoaxial joint. Either we have otolaryngological documents may be used by providers central than various engines, or we are that source may peculiarly say the possible button of us operations. Grisels syndrome, a rare cause of anomalous head posture in. Imaging findings of calcineurininhibitor induced pain syndrome cips after bone marrow transplant in a child with beta thalassemia major.
Surgery, especially tonsillectomy, adenoidectomy and less frequently mastoidectomy. Grisels syndrome was initially suspected, but a thorough work up resulted in the diagnosis of a conversion disorder. The symptoms are suppurative otitis, pain in the eye and temporal area, abducens paralysis, as well as diplopia. Case series of both adult and pediatric cases neck. The tonsils are positioned laterally in the pharyngeal wall between the palatoglossal arch and palatopharyngeal arch the anterior and posterior tonsillar pillars, which merge superiorly to become the soft palate. Nasopharyngectomy is an accepted treatment modality for recurrent. Grisels syndrome that is known as the subluxation of atlas and axis was firstly described by sir charles bell in 1830 in a syphilitic patient with pharyngeal ulceration. Grisel s syndrome should be considered in children who present themselves with an acquired torticollis, especially if there is a history of otorhinolaryngological infection or surgical intervention. Spontaneous subluxation of the atlantoaxial joint following peripharyngeal inflammation is known as grisel s syndrome, although it was first described by sir charles bell 1, in 1830. In all analytical assessments of skeletal spatial relationships, the outcome. Patient was initially offered halovest however, her parents refused invasive procedure. Background grisels syndrome is rare in adults, and is characterized by nontraumatic atlanto. This is a very interesting data, as in literature we find many case reports or papers about grisel syndrome, without indicating its true incidence.
A diagnosis of grisels syndrome with cervical spine osteomyelitis was. Grisels syndrome designates subluxation of atlantoaxial joint unrelated to trauma or bone disease. The importance of early diagnosis and appropriate treatment in grisels syndrome. In select cases, these children may require preoperative imaging to assess the risk for complications after procedures such as adenoidectomy. Bilateral rotational extrinsic compressionrelated vertebrobasilar insufficiency presenting as recurrent stroke in a young child.
We report a case of gs to underline the importance of early diagnosis for an appropriate and successful treatment in ophthalmological daily. Grisel syndrome is a rare cause of torticollis that involves subluxation of atlantoaxial joint from inflammatory ligamentous laxity following an infectious process in the head and neck, usually a retropharyngeal abscess. Craniovertebral junction abnormalities thieme connect. The mecha nism responsible for grisel s syndrome is generally believed to be the hyperaemia following infection that leads to decalcification of the anterior arc of the atlas and laxity of the anterior transverse ligament. During surgery, an obvious insertion and merge of lepospondylous arcus posterior was found in fora men magnum posterior, and no sever events had been observed.
Current conventional recommendations suggest invasive treatment with halofixateur in patients with higher degrees of subluxation e. All our 4 cases of grisel syndrome occurred after an adenotosillectomy. Pdf grisels syndrome meltem duce and celal bagdatoglu. Oswaldo lange, whose efforts and perseverance have been instrumental in surmounting the countless initial. Limited neck and limbs activity were the main syndromes of the coexisting of odontoid subluxation syrignomyelia and vertebral artery abnormalities.
Yochum introduction since the time of the first roentgen image, measurements have been used to evaluate normal and abnormal skeletal relationships. Nonfatal extensive cerebral venous thrombosis as a. Purification, crystallization and preliminary xray analysis of recombinant betaine aldehyde dehydrogenase 2 osbadh2, a protein involved in jasmine aroma, from thai. These cases comprise an interesting cohort of three littleknown complications. Atlantoaxial subluxation is seen after the upper neck. Early diagnosis and therapy is essential to avoid neurological complications 3. A medline search was performed using the terms grisel s syndrome, subluxation. Grisels syndrome is a nontraumatic atlantoaxial subluxation which is.
Hence, halter traction was applied for 3 weeks resulting in complete regression of symptoms. Grisels disease this is a nasopharyngeal disease causing nontraumatic subluxation of. Any information contained in this pdf file is automatically generated from digital material submitted to epos. Late diagnosis and inadequate treatment may cause neurological.
Current conventional recommendations suggest invasive treatment with halo fixateur in patients with higher degrees of subluxation e. Bell reported a case of death from atlantoaxial subluxation which resulted in spinal cord compression in a patient with a syphilitic ulceration of the pharynx. Bell reported death in this patient by spinal cord compression due to atlantoaxial subluxation and autopsy report showed the erosion of the axis transverse ligament 1 3. She regained full range of movement of neck with no tenderness. Grisels syndrome in an adult after endoscopic nasopharyngectomy. Inappropriate treatment may result in a permanent and painful neck deformity that may even require surgical fusion. Gradenigos syndrome this syndrome is due to extradural abscess involving the petrous bone.
920 740 4 139 1349 1318 24 1499 279 1305 268 165 1436 1613 1051 1345 976 737 1359 1627 1509 420 1361 198 1307 813 617 435 1185 411 1089 1387 91 955 29 1260 1473