Grisel Syndrome
A Review
Grisel syndrome is defined as atlanto-axial subluxation following infections of upper airway. These patients present with torticollis which is persistent. Radiology is normal in these patients. This is actually a sinister problem which should always be kept in mind before taking up a patient for adenotonsillectomy. Subclinical subluxation of atlanto-axial joint may become overt causing brain stem compression following adenotonsillectomy surgery. This actually occurs because the paraspinal muscles are relaxed (due to the use of muscle relaxants) during the procedure. The actual position of tonsillectomy (Rose position) aggravates this condition. This article attempts to explore this problem with a review of 10 year published literature on this subject.
