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Neuropediatrics 2015; 46(01): 069-071
DOI: 10.1055/s-0034-1393709
Short Communication
Georg Thieme Verlag KG Stuttgart · New York

A Painful Stiff Neck following an Ear, Nose, and Throat Surgical Procedure: Case Report

Elena Pavlidis
1   Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, Parma, Italy
,
Cristiana Copioli
1   Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, Parma, Italy
,
Carlotta Spagnoli
1   Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, Parma, Italy
,
Silvia Mazzotta
1   Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, Parma, Italy
,
Francesca Ormitti
2   Neuroradiology, Neuroscience Department, University of Parma, Parma, Italy
,
Girolamo Crisi
2   Neuroradiology, Neuroscience Department, University of Parma, Parma, Italy
,
Francesco Pisani
1   Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, Parma, Italy
› Author Affiliations
Further Information

Publication History

23 April 2014

25 July 2014

Publication Date:
09 November 2014 (online)

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Abstract

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.

Keywords

stiff neck - torticollis - atlantoaxial subluxation - Grisel syndrome
 

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