A previously healthy 2-year-old boy was hospitalized after 2 weeks of persistent fever (temperature to a maximum of 38.9C [102F]) and a 2-day history of neck stiffness. There was no history of cough, rhinorrhea, or dysphagia. [pediatricsconsultantlive.com]

A previously healthy 2-year-old boy was hospitalized after 2 weeks of persistent fever (temperature to a maximum of 38.9 C [102 F]) and a 2-day history of neck stiffness. There was no history of cough, rhinorrhea, or dysphagia. [consultant360.com]

Boy • Torticollis, halitosis, cough, odynophagia for 1/52 • No fever • PE: – posture in right-sided head rotation – Subtle flexion – Ipsilateral SCM spasm – Nuchal pain – Hypertrophied tonsils, no abcess – Normal Neuro exam • Lab: N crp and WBC 5. • CT [de.slideshare.net]

Her recent clinical history revealed cough and fever from the day before the neck stiffness' onset, which spontaneously regressed in 2-3 days; no trauma was reported. [pediatricneurosciences.com]

Case Report The patient was a 3-year-old boy with no relevant history except for a dubious allergy to amoxicillin, who presented right otalgia with otorrhea and fever (38.6 C) of 3 days duration despite treatment with oral clarithromycin and topical ciprofloxacin [elsevier.es]

Post-operative inflammation after certain procedures such as adenoidectomy can also lead to this condition in susceptible individuals such as those with Down's syndrome. [youtube.com]

Residual subluxation after 8 weeks of treatment or neurological symptoms may require operative treatment. abnormal ligament laxity Down syndrome connective tissue diseases cervical spine instability osteogenesis imperfecta neurofibromatosis type 1 undetected [radiopaedia.org]

Craniovertebral junction abnormalities in Down syndrome. Neurosurgery. 2010 Mar. 66(3 Suppl):32-8. [Medline]. American Academy of Pediatrics Committee on Sports Medicine & Fitness. Atlantoaxial instability in Down syndrome: subject review. [medscape.com]

syndrome). 1,2 In Grisel syndrome, ligament laxity is associated with pharyngeal infection or head and neck surgery. 3,4 This disorder occurs primarily in children: 90% of cases occur in persons younger than 21 years. 5,6 Patients typically present with [consultant360.com]

Children and patients with Down syndrome, who have an increased laxity of the atloaxoid ligaments and a greater atlanto-odontoid distance, are the most affected. [elsevier.es]

We opted for admission to the paediatric ICU due to suspicion of sepsis. [elsevier.es]

There was no history of cough, rhinorrhea, or dysphagia. The oropharynx could not be examined because of neck stiffness. The patient had bilateral anterior cervical lymphadenopathy. [pediatricsconsultantlive.com]

Boy • Torticollis, halitosis, cough, odynophagia for 1/52 • No fever • PE: – posture in right-sided head rotation – Subtle flexion – Ipsilateral SCM spasm – Nuchal pain – Hypertrophied tonsils, no abcess – Normal Neuro exam • Lab: N crp and WBC 5. • CT [de.slideshare.net]

Her recent clinical history revealed cough and fever from the day before the neck stiffness' onset, which spontaneously regressed in 2-3 days; no trauma was reported. [pediatricneurosciences.com]

His oropharynx was not erythematous; the uvula was in the midline and there was no tonsillar hypertrophy. The patient was reluctant to move his neck in any direction, but especially side-to-side. There were no other notable physical findings. [pediatricsconsultantlive.com]

On admission she presented, at physical examination, with right torticollis, sore throat, tonsillar hypertrophy and hyperemia; neurological examination reported no deficits. [pediatricneurosciences.com]

Boy • Torticollis, halitosis, cough, odynophagia for 1/52 • No fever • PE: – posture in right-sided head rotation – Subtle flexion – Ipsilateral SCM spasm – Nuchal pain – Hypertrophied tonsils, no abcess – Normal Neuro exam • Lab: N crp and WBC 5. • CT [de.slideshare.net]

Boy • Torticollis, halitosis, cough, odynophagia for 1/52 • No fever • PE: – posture in right-sided head rotation – Subtle flexion – Ipsilateral SCM spasm – Nuchal pain – Hypertrophied tonsils, no abcess – Normal Neuro exam • Lab: N crp and WBC 5. • CT [de.slideshare.net]

Progressive throat and neck pain and neck stiffness can be followed by neurologic symptoms such as pain or numbness radiating to arms (radiculopathies). [youtube.com]

On the day before readmission, the patient continued to show signs of fatigue and neck pain. His parents noted that while riding in their car, the patient held his neck with both hands-especially when the ride became bumpy. [pediatricsconsultantlive.com]

• KarKos et al : – Systemic review 71 articles – 96 Pt with C1 C2 subluxation – All no hx. of trauma – 48% had recent URTI – 40% post neck procedures – Clinical picture: torticollis,neck pain maily in nape – Signs: – Palpable deviation spinous process [de.slideshare.net]

On the day before readmission, the patient continued to show signs of fatigue and neck pain. His parents noted that while riding in their car, the patient held his neck with both hands—especially when the ride became bumpy. [consultant360.com]

Atlantoaxial instability in acute odontoid fractures is associated with nonunion and mortality. Spine J. 2015 May 1. 15 (5):910-7. [Medline]. Zikou AK, Alamanos Y, Argyropoulou MI, Tsifetaki N, Tsampoulas C, Voulgari PV, et al. [medscape.com]

He was irritable, however, and lay in bed with his head tilted to the left. His oropharynx was not erythematous; the uvula was in the midline and there was no tonsillar hypertrophy. [pediatricsconsultantlive.com]

Pathphysiology • Unknown • Grisel emphasize the role of muscle spasm • Tedesco et al – Cervical lympadenitis induce irritative spasm of suboccipital and parvertebral muscles. • Most accepted theory is by Parke et al. – Studied vascularization of c spine [de.slideshare.net]

In extreme cases, the condition can lead to quadriplegia and even death from acute respiratory failure. [youtube.com]

These last 2 types are more severe and have been associated with spinal cord compression, quadriplegia and even death. They require cervical traction, immobilisation and bed rest. [elsevier.es]

The most common etiologies 2 are as follows: upper respiratory tract infections tonsillectomy/adenotonsillectomy otitis media other ENT infections/surgery The causative organisms are usually 3 : Staphylococcus aureus Group B. [radiopaedia.org]