Korean J Spine.  2015 Jun;12(2):84-87. 10.14245/kjs.2015.12.2.84.

Grisel's Syndrome Induced by Mycobacterium tuberculosis

• Lee JK
• Oh CH
• Park HC
• Yoon SH

• KMID: 1927564
• DOI: http://doi.org/10.14245/kjs.2015.12.2.84

Abstract

Grisel's syndrome is a non-traumatic subluxation of the atlantoaxial joints, which is caused by an inflammatory process in the upper neck. It is rare to find literary reports of Grisel's syndrome with an evident pathogen in a lesion. For the first time in Korea, we report a 36-year-old female with Grisel's syndrome having an atlantoaxial subluxation, which was caused by a retropharyngeal abscess secondary to pulmonary Mycobacterium tuberculosis. The patient was treated with an anti-tuberculosis regimen and was prescribed a Philadelphia collar for the control of torticollis. The result of magnetic resonance imaging (MRI) showed an improved atlantoaxial alignment, after drug treatment and immobilization. This patient was neurologically intact and free from symptomatic complaints at follow-up visit. Dynamic cervical radiograph confirmed that the atlantoaxial joints had been stable. The pathophysiology of Grisel's syndrome, along with anatomical attributes, was explained on the basis of the patient's clinical course.

Keyword

Grisel's syndrome; Mycobacterium tuberculosis; Non-traumatic atlantoaxial rotatory subluxation; Torticollis

MeSH Terms

Adult
Atlanto-Axial Joint
Female
Follow-Up Studies
Humans
Immobilization
Korea
Magnetic Resonance Imaging
Mycobacterium tuberculosis*
Neck
Retropharyngeal Abscess
Torticollis