Grisel's syndrome: an unusual cause of torticollis.
OBJECTIVE
The objective of this paper is to present a case series of patients with diagnosis of torticollis due to Grisel's syndrome and, in doing so, raise awareness of an unusual condition that could be fatal. A review of the literature is presented regarding diagnosis and treatment.


METHODS
Case series of three patients that were 7, 10, and 12 years old with history of tonsillitis or neck surgery consulted to the service of Rehabilitation Medicine.


RESULTS
Physical examination showed a fixed head or limitation of movement to neutral position and initially a normal neurological examination. Initial cervical X-rays were not diagnostic. The final diagnosis was made by CT scan or MRI. All 3 patients were treated with anti-inflammatory medications, immobilization, and/or cervical traction or surgery.


CONCLUSIONS
Grisel's syndrome is a non-traumatic atlanto-axial rotatory fixation (AARF) with or without subluxation following infection or surgery in the head or neck region. This paper presents an unusual cause of torticollis that could be fatal or cause neurological injury if not recognized and treated appropriately.
Physical Medicine, Rehabilitation, and Sports Medicine Department, University of Puerto Rico, San Juan, Puerto Rico.
Gerardo L
GL
Ortiz
Ivette
I
Pratts
Edwardo
E
Ramos
D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009333:Neck / Q000503:physiopathology* / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D014069:Tonsillitis / Q000150:complications*; D014103:Torticollis / Q000175:diagnosis / Q000209:etiology*
Grisel's syndrome; Torticollis; atlantoaxial rotatory fixation; atlantoaxial subluxation; children