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Grisel syndrome: a delayed presentation in an asymptomatic patient

Published online by Cambridge University Press:  13 February 2007

J Doshi*
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle Upon Tyne, UK.
S Anari
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle Upon Tyne, UK.
I Zammit-Maempel
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle Upon Tyne, UK.
V Paleri
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle Upon Tyne, UK.
*
Address for correspondence: Mr Jayesh Doshi, Apartment 20, Adderstone Court, 17 Adderstone Crescent, Jesmond, Newcastle upon Tyne NE2 2EA, UK. Fax: 01706 646734 E-mail: jayeshdoshi@hotmail.com

Abstract

Grisel syndrome is a rare condition characterised by atlanto-axial subluxation following an inflammatory process in the head and neck region. It occurs more commonly in children and usually presents with cervical pain and torticollis, in addition to symptoms of the primary infection. We present the case of an asymptomatic 78-year-old man who was incidentally found to have atlanto-axial subluxation on a routine follow-up computed tomography scan, three months following successful treatment of a skull base infection. This case emphasises the importance of appropriate follow-up imaging for patients with skull base infections, even if they respond clinically to medical treatment.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2007

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Footnotes

Presented as a poster at the 42nd South African ENT Congress, in conjunction with the South African Head and Neck Oncology Society, 8–11 October 2006, Cape Town, South Africa.

References

1Welinder, NR, Hoffman, P, Hakansson, S. Pathogenesis of non traumatic atlanto-axial subluxation (Grisel's syndrome). Eur Arch Otorhinolaryngol 1997;254:251–4CrossRefGoogle Scholar
2Samuel, D, Thomas, DM, Tierney, PA, Patel, KS. Atlanto-axial subluxation (Grisel's syndrome) following otolaryngological diseases and procedures. J Laryngol Otol 1995;109:1005–9CrossRefGoogle ScholarPubMed
3Wetzel, FD, LaRocca, H. Grisel's syndrome: a review. Clin Orthop 1989;240:141–52Google Scholar
4Fielding, JW, Hawkins, RJ. Atlanto-axial rotary fixation. J Bone Joint Surg Am 1977;59:3744CrossRefGoogle Scholar
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