急性鼻咽炎後合併寰軸椎關節脫位－二例報告

Atlantoaxial Subluxation Followed by Acute Rhinopharyngitis - Report of Two Cases

薛智峰(Jee-Fong Hsueh) ； 彭玉文(Yue-Wen Pen) ； 張雅慧(Ya-Huei Chang) ； 周延隆(Yen-Long Jou) ； 王國榮(Kuo-Rong Wang)

《中華民國耳鼻喉科醫學會雜誌》 32卷2期 (1997/04) Pp. 191-196

https://doi.org/10.6286/1997.32.2.191

摘要

Grisel氐症候群是指頭頸部發生感染後導致的第1、第2頸椎關節脫位，因而產生頸痛及斜頸現象。病例很罕見，通常發生在兒童，致病機轉尚未明瞭。一般將寰軸椎關節按脫位程分成4型，以第1型最常見，預後也最好，目前以電腦斷層攝影最具診斷價值，早期治療始可避免形成永久性斜頸。近來本科曾經歷2例，病程極類似，皆是急性鼻咽炎發生不久後產生漸進性斜頸以及頭部活動受限。2名病人在懷疑為寰軸椎關節脫位的診斷下，均迅速給予全身性抗生素並會診復健科予以圈固定，1星期後，兩者鼻咽炎症狀、斜頸及頭部活動都獲得顯著改善，且在數星期後完全恢復正常而無任何併發症。

關鍵字

斜頸 ； Grisel氐症候群 ； 寰軸椎關節脫位

並列摘要

Spontaneous atlanto-axial subluxation with neck pain and torticollis followed by head and neck infection is known as Grisel’s syndrome. It is very rare and most often occurs in children. The real patho-genesis is not fully understood. Clinically, it classifies four types. Computerized tomography is the best method of diagnos-tic confirmation. Early treatment is manda-tory to avoid permanent torticollis. Here we reported two cases of Grisel’s syndrome. Both of them developed progressive torti-collis and limited head movement shortly after acute rhinopharyngitis. Under the impression of atlantoaxial subluxation, empirical systemic antibiotics were adminis-trated and cervical collar were applied. One week later, the symptoms subsided. The patients have recovered without any sequela.

並列關鍵字

torticollis ； Grisel's syndrome ； atlanto-axial subluxation