title: Atlanto axial rotatory dislocation in adults: a rare complication of an epileptic seizure--case report.
abstract: Atlanto Axial Rotatory Dislocations (AARDs) are a heterogeneous group of post-traumatic pathologies typical of the pediatric age, and rare in adults. We describe the case of a 34-year-old woman, developing Atlanto Axial Rotatory Fixation (AARF) after a generalized tonic-clonic epileptic seizure, an extremely rare traumatic cause never described in literature. AARF was detected only 1 month after the accident and nonsurgical treatment was attempted at the beginning. The patient underwent surgery only 2 months after the accident. The best treatment should be conservative reduction within 1 month; when it is not possible, it is advisable to perform surgery as soon as possible. C1-C2 fixation with Harm's technique is the gold standard for fixed luxations. Delay of treatment makes intraoperative reduction more difficult and increase the establishment of the chronic permanent change of neck muscles and ligaments.
authors.affiliation: Department of Neurosurgery, Sapienza University of Rome.
authors.forename: Roberto
authors.initials: R
authors.lastname: Tarantino
authors.forename: Pasquale
authors.initials: P
authors.lastname: Donnarumma
authors.forename: Nicola
authors.initials: N
authors.lastname: Marotta
authors.forename: Paolo
authors.initials: P
authors.lastname: Missori
authors.forename: Ilaria
authors.initials: I
authors.lastname: Viozzi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Landi
authors.forename: Roberto
authors.initials: R
authors.lastname: Delfini
mesh_terms: D000328:Adult; D038481:Anterior Temporal Lobectomy; D000927:Anticonvulsants / Q000627:therapeutic use; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000601:surgery; D001863:Bone Screws; D003078:Colchicine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003131:Combined Modality Therapy; D057210:Delayed Diagnosis; D003951:Diagnostic Errors; D004351:Drug Resistance; D004830:Epilepsy, Tonic-Clonic / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D008022:Ligaments / Q000473:pathology; D008279:Magnetic Resonance Imaging; D019547:Neck Pain / Q000209:etiology; D009989:Orthotic Devices; D012399:Rotation; D014057:Tomography, X-Ray Computed; D014103:Torticollis / Q000175:diagnosis; D014143:Traction
chemical_list: D000927:Anticonvulsants; D003078:Colchicine; C004280:thiocolchicoside