PATHOGENESIS OF NONTRAUMATIC ATLANTOAXIAL SUBLUXATION (GRISELS-SYNDROME)

Non-traumatic atlanto-axial subluxation (AAS) is an uncommon complicat ion of upper neck inflammatory processes and head and neck surgery. It is also known under the eponym of Grisel's syndrome (GS). We present a case report of a 6-year-old boy with GS that resulted from a retroph aryngeal abscess. A diagnosis was not made until 2 months after the oc currence of infection. Re-evaluation of repeated CT scans of the neck showed the sequential development of AAS. These findings implied that the pathogenesis of GS is a distention of the ligaments between the at las and axis rather than loosening of the ligaments caused by the spre ad of an inflammatory edema from the soft tissues of the neck as has b een proposed by others.