A painful stiff neck following an ear, nose, and throat surgical procedure: case report.
Grisel syndrome is a rare, nontraumatic atlantoaxial subluxation, typical of developmental ages and characterized by head flexion/rotation and painful fixation. Neurological symptoms may occur. It is secondary to head/neck infections and ear, nose, and throat surgery (adenoidectomy, tonsillectomy, and mastoidectomy). Here, we report the case of a child who presented a painful stiff neck following an adenotonsillectomy, with imaging evidencing an atlantoaxial subluxation. The child showed improvement in his condition following a conservative treatment with antibiotics, anti-inflammatory, and analgesic therapy and cervical collar. We believe it is of great significance for clinicians taking into account this peculiar condition in the differential diagnosis of a stiff neck in pediatric patients, thus avoiding misdiagnosis and delays. Indeed, its diagnosis is mainly based on a focused anamnesis associated with the detection of the typical neuroradiological findings.
Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, Parma, Italy.
Elena
E
Pavlidis
Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, Parma, Italy.
Cristiana
C
Copioli
Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, Parma, Italy.
Carlotta
C
Spagnoli
Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, Parma, Italy.
Silvia
S
Mazzotta
Neuroradiology, Neuroscience Department, University of Parma, Parma, Italy.
Francesca
F
Ormitti
Neuroradiology, Neuroscience Department, University of Parma, Parma, Italy.
Girolamo
G
Crisi
Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, Parma, Italy.
Francesco
F
Pisani
D000233:Adenoidectomy / Q000009:adverse effects; D002648:Child; D006261:Headache / Q000150:complications / Q000209:etiology; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D009333:Neck / Q000503:physiopathology*; D019547:Neck Pain / Q000150:complications / Q000209:etiology; D010146:Pain / Q000209:etiology* / Q000473:pathology*; D011183:Postoperative Complications / Q000503:physiopathology*; D015898:Tomography Scanners, X-Ray Computed; D014103:Torticollis / Q000150:complications / Q000209:etiology