Grisel's Syndrome

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Classification according to ICD-10
M43.6 Torticollis
ICD-10 online (WHO version 2019)

The Grisel's syndrome refers to a subluxation of the cervical spine in atlantoaxial due to pain-related posture on the basis of inflammation in the ear, nose and throat area.

Synonyms are Watson-Jones disease and torticollis atlantoepistrophealis .

The name goes back to the first person to describe it, the French surgeon Pierre Grisel (1869-1959).

root cause

Grisel's syndrome can occur post-traumatically, in the context of rheumatic diseases, after soft tissue inflammation in the nasopharynx such as tonsillitis, but also after operations such as removal of the tonsils.

Clinical manifestations

Clinical criteria are:

  • Severe neck pain
  • Tilted head
  • Displacement of the atlas to the side with subluxation

Investigation methods

The diagnosis can be suspected in the X-ray image , the more precise representation including the cause is carried out by means of magnetic resonance imaging .

Differential diagnosis

A torticollis has another cause to be distinguished:

  • Congenital muscular torticollis
  • Klippel-Feil Syndrome
  • Torticollis in the case of unilateral hearing loss or disturbance of the balance organ
  • muscular due to tension

therapy

As a rule, conservative treatment is sufficient; surgical revision is carried out in the case of abscesses.

literature

  • P. Kasten, J. Zeichen, T. Gösling, C. Krettek: Grisel's Syndrome - a rarity in trauma surgery. In: The trauma surgeon. Vol. 105, No. 6, June 2002, pp. 565-568, ISSN  0177-5537 . PMID 12132197 .
  • HJ Teske, H. Chüden: The atlas displacement as a consequence of inflammatory changes or surgical interventions in the nasopharynx. In: Advances in X-Ray and Nuclear Medicine. Vol. 113, No. 4, October 1970, pp. 519-522, ISSN  0015-8151 . PMID 5534478 .

Individual evidence

  1. ↑ a b B. Leiber: The clinical syndromes. Syndromes, sequences and symptom complexes. Edited by G. Burg, J. Kunze, D. Pongratz, PG Scheurlen, A. Schinzel, J. Spranger, 7th edition. Urban & Schwarzenberg 1990, ISBN 3-541-01727-9
  2. ↑ a b Lexicon Orthopedics
  3. ↑ Grisel, P .: Enucléation de l'atlas et torticollis nasopharyngia. In: Ref. Zbl. Chir. , Vol. 58, 1931, p. 432.
  4. ↑ Guide to Grisel Syndrome

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