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Eponym

Grisel syndrome

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Abstract

Grisel syndrome or atlantoaxial non-traumatic subluxation is a rare entity, poorly described in pediatric literature, although it is a pathology that usually appears in young children. The typical presentation is a torticollis with a previous surgical antecedent (mainly a surgery of the ear, nose, and throat area like adenoidectomy) or after an upper tract respiratory infection. A prompt diagnosis is essential for a successful evolution, and the treatment in most cases is conservative. We report a case of an 8-year-old girl with a typical evolution of this unusual complication. In our case, the most important element for diagnosis was the 3D CT scanner, and the treatment was conservative with a successful outcome. Pediatricians should be aware of this rare but potentially serious entity to establish the correct treatment and avoid complications.

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Acknowledgments

The authors gratefully acknowledge the assistance of Rachael Dix in manuscript’s edition.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Consorcio Hospital General Universitario, Valencia, Spain

    Graciela Ortega-Evangelio, Jose Juan Alcon, Julio Alvarez-Pitti, Maria Juncos & Empar Lurbe

  2. Department of Physical Medicine and Rehabilitation, Hospital Universitario La Fe, Valencia, Spain

    Vicente Sebastia

Authors
  1. Graciela Ortega-Evangelio
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  2. Jose Juan Alcon
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  3. Julio Alvarez-Pitti
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  4. Vicente Sebastia
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  5. Maria Juncos
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  6. Empar Lurbe
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Corresponding author

Correspondence to Graciela Ortega-Evangelio.

Additional information

Key points

  1. 1.

    The main causes of Grisel syndrome are infection (48%) and post-adenotonsillectomy (31%).

  2. 2.

    Less common causes include other postoperative cases such as pharyngoplasty and ear operations.

  3. 3.

    Neurosurgical consultation is paramount in all cases, even the mild ones.

  4. 4.

    In the majority of cases, conservative management in the form of bed rest, antibiotics, muscle relaxants, and collar with or without traction, is effective.

  5. 5.

    In a few cases only, surgery in the form of arthrodesis is deemed necessary.

  6. 6.

    Morbidity is significant in those cases where diagnosis is delayed, with the most devastating consequence, a permanent neurological deficit.

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Ortega-Evangelio, G., Alcon, J.J., Alvarez-Pitti, J. et al. Eponym. Eur J Pediatr 170, 965–968 (2011). https://doi.org/10.1007/s00431-011-1493-7

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  • DOI: https://doi.org/10.1007/s00431-011-1493-7

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