Background: Anomalous head posture (AHP) or torticollis is a relatively common condition in children. Torticollis is not a diagnosis, but it is a sign of underlying disease. Grisel's syndrome (GS) is a rare condition of uncertain etiology characterized by a nontraumatic atlanto-axial subluxation (AAS), secondary to an infection in the head and neck region. It has not been considered, in ophthalmological papers, as a possible cause of AHP. Case presentation: A case of AAS secondary to an otitis media is studied. The children showed neck pain, head tilt, and reduction in neck mobility. The patient had complete remission with antibiotic and anti-inflammatory therapy and muscle relaxants. Signs of GS should always be taken into account during ophthalmological examination (recent history of upper airway infections and/or head and neck surgeries associated to a new onset of sudden, painful AHP with normal ocular exam). In such cases it is necessary to require quick execution of radiological examinations (computer tomography and/or nuclear magnetic resonance), which are essential to confirm the diagnosis. Conclusion: GS is a multidisciplinary disease. We underline the importance of an accurate orthoptic and ophthalmological examination. Indeed, early detection and diagnosis are fundamental to achieve proper management, avoid neurological complications and lead to a good prognosis.

Grisel's syndrome, a rare cause of anomalous head posture in children : A case report / D. Allegrini, A. Autelitano, E.A. Nocerino, P. Fogagnolo, S. De Cillà, L. Rossetti. - In: BMC OPHTHALMOLOGY. - ISSN 1471-2415. - 16:1(2016). [10.1186/s12886-016-0197-1]

Grisel's syndrome, a rare cause of anomalous head posture in children : A case report

D. Allegrini
Primo
;
A. Autelitano
Secondo
;
E.A. Nocerino;P. Fogagnolo;L. Rossetti
Ultimo
2016

Abstract

Background: Anomalous head posture (AHP) or torticollis is a relatively common condition in children. Torticollis is not a diagnosis, but it is a sign of underlying disease. Grisel's syndrome (GS) is a rare condition of uncertain etiology characterized by a nontraumatic atlanto-axial subluxation (AAS), secondary to an infection in the head and neck region. It has not been considered, in ophthalmological papers, as a possible cause of AHP. Case presentation: A case of AAS secondary to an otitis media is studied. The children showed neck pain, head tilt, and reduction in neck mobility. The patient had complete remission with antibiotic and anti-inflammatory therapy and muscle relaxants. Signs of GS should always be taken into account during ophthalmological examination (recent history of upper airway infections and/or head and neck surgeries associated to a new onset of sudden, painful AHP with normal ocular exam). In such cases it is necessary to require quick execution of radiological examinations (computer tomography and/or nuclear magnetic resonance), which are essential to confirm the diagnosis. Conclusion: GS is a multidisciplinary disease. We underline the importance of an accurate orthoptic and ophthalmological examination. Indeed, early detection and diagnosis are fundamental to achieve proper management, avoid neurological complications and lead to a good prognosis.
anomalous head posture; grisel's syndrome; non-traumatic atlanto-axial subluxation; ocular motility; anti-bacterial agents; anti-inflammatory agents; atlanto-axial joint; dislocations; humans; imaging, three-dimensional; infant; joint diseases; magnetic resonance imaging; male; muscle relaxants, central; neck pain; ocular motility disorders; orthodontic brackets; pharyngitis; tomography, x-ray computed; torticollis; posture; ophthalmology
Settore MED/30 - Malattie Apparato Visivo
2016
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/446335
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