title: Atlantoaxial dislocation related to instilling eyedrops in a patient with Down's syndrome.
abstract: OBJECTIVE
  To alert ophthalmologists of the risk of hyperextending the neck of patients with Down's syndrome while holding them to instill eyedrops.
  
  
  METHODS
  We describe a case of atlantoaxial dislocation related to instilling eyedrops in a 6-year-old girl with Down's syndrome.
  
  
  RESULTS
  Early recognition of the problem allowed prompt treatment and partial recovery of the patient.
  
  
  CONCLUSIONS
  Examination and clinical maneuvers in a child with Down's syndrome require gentleness and avoidance of hyperextension of the neck to prevent spinal cord injury.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Scientific Institute S Raffaele Hospital, University of Milan, Italy, pnucci@micronet.it
authors.forename: P
authors.initials: P
authors.lastname: Nucci
authors.forename: M
authors.initials: M
authors.lastname: de Pellegrin
authors.forename: R
authors.initials: R
authors.lastname: Brancato
mesh_terms: D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000293:injuries*; D002648:Child; D002985:Clinical Protocols; D003519:Cyclopentolate / Q000008:administration & dosage*; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D009883:Ophthalmic Solutions; D011859:Radiography
chemical_list: D009883:Ophthalmic Solutions; D003519:Cyclopentolate