What is Grisel syndrome in atlantoaxial instability (AAI)?

Updated: May 13, 2020
  • Author: Daniel P Leas, MD; Chief Editor: Jeffrey A Goldstein, MD  more...
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Grisel syndrome is the occurrence of atlantoaxial subluxation (AAS) following inflammation of adjacent soft tissues after a pharyngeal infection or surgical intervention. Primarily seen in children aged 5-12 years (though possible in adults), its etiology and pathoanatomy are not totally understood. Parke demonstrated direct connection between the periodontal venous plexus and the pharyngovertebral veins. [7] This may provide a route for exudates to be transported to the cervical spine, creating a local inflammatory reaction.

In addition, children appear to be more susceptible secondary to their steeper dens-facet angle and rich vascular folds in the atlantoaxial and lateral atlantoaxial joint.

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