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

BMC Ophthalmology

Case Report

Alessandro Autelitano¹  Paolo Fogagnolo¹  Luca Rossetti¹  Stefano De Cillಠ Davide Allegrini³  Elisabetta Nocerino⁴ 

[1] Eye Clinic, San Paolo Hospital, University of Milan, Via di Rudini’ 8, 20142, Milan, Italy;Eye Clinic, San Paolo Hospital, University of Milan, Via di Rudini’ 8, 20142, Milan, Italy;Unit of Ophthalmology, Maggiore della Carità Hospital, Novara, Italy;Eye Clinic, San Paolo Hospital, University of Milan, Via di Rudini’ 8, 20142, Milan, Italy;Unit of Ophthalmology, Melegnano Hospital, Vizzolo Predabissi, Milan, Italy;Unit of Radiology, San Paolo Hospital, University of Milan, Milan, Italy;

关键词: Anomalous head posture;    Grisel’s syndrome;    Non-traumatic atlanto-axial subluxation;    Ocular motility;   

DOI  :  10.1186/s12886-016-0197-1

 received in 2015-07-23, accepted in 2016-02-23,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAnomalous 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 presentationA 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.ConclusionGS 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.

【 授权许可】

CC BY   
© Allegrini et al. 2016