Torticollis at Grisel’s Syndrome – Case Reports

Czech version

Authors: T. Rybnikár ¹; V. Málek ²; P. Čelakovský ¹; Viktor Chrobok ¹ ; Jan Mejzlík ³ ; D. Kalfeřt ¹; Jana Dědková ⁴; E. Popper ⁵
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku LF UK a FN Hradec Králové ¹; Neurochirurgická klinika LF UK a FN Hradec Králové ²; Klinika otorinolaryngologie a chirurgie hlavy a krku FZS UP a Pardubická krajská nemocnice, a. s. ³; Radiologická klinika LF UK a FN Hradec Králové ⁴; Rehabilitační klinika LF UK a FN Hradec Králové ⁵
Published in: Cesk Slov Neurol N 2013; 76/109(2): 246-249
Category: Case Report

Overview

Rotational atlantoaxial instability may lead to torticollis and has diverse aetiology. Grisel’s syndrome is one of the potential causes of rotational atlantoaxial instability. Grisel’s syndrome is a rare condition that manifests itself with spastic contraction of the neck muscles that limits movement of the head and neck. It may occur following a surgery, especially otorhinolaryngological, requiring a specific head position with hyperextension or hyperextension with rotation, or in connection with bacterial infections of the cervical area. Increased incidence in adolescence is explained by increased perfusion of the atlantoaxial space and increased ligamentous laxity of the joint capsules and allar ligament length in children with known horizontal orientation of zygapophyzeal joints between the first and the second cervical vertebrae. The presented case reports describe post-surgical development of Grisel’s syndrome in two paediatric patients. The authors highlight the importance of early diagnosis, emphasising interdisciplinary cooperation. Late diagnosis can cause serious complications including root deficits, myelopathy or cosmetic deformity of the cervical spine.

Key words:
Grisel’s syndrome – rotational atlantoaxial instability – torticollis

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