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
