Grisel syndrome: pathophysiological evidence from magnetic resonance imaging findings.
Grisel syndrome is a condition of uncertain etiology characterized by a non-traumatic atlantoaxial subluxation following an infection in the head and neck region. Although first described in 1830, the exact pathophysiology of Grisel syndrome remains unclear. We present a case of atlantoaxial subluxation after acute lymphadenitis diagnosed with a dynamic computed tomography (CT) and magnetic resonance imaging (MRI). A previously healthy 9-year-old male patient presented with torticollis of sudden onset. Dynamic CT and MR imaging showed rotary atlantoaxial subluxation and inflammation surrounding the cervical spinal ligaments. A follow-up MRI of the cervical spine, taken 3 weeks after the onset of symptoms, showed a complete resolution of subluxation and inflammation surrounding the cervical spinal ligaments. In this case report, we support the hypothesis that an inflammation-induced laxity of the cervical ligaments is the pathologic key to Grisel syndrome using radiologic findings.
Department of Physical Medicine and Rehabilitation, Institute for Medical Sciences, Chonbuk National University Medical School, Chonbuk National University Hospital, Jeonju, Korea.
See-Hyun
SH
Park
Sung-Hee
SH
Park
Sang-Hee
SH
Lee
Atlantoaxial joint; Lymhadenitis; Torticollis