Grisel's syndrome: The two-hit hypothesis-A case report and literature review

July 31, 2004 by Andrew P. Battiata, MS, MD, CPT, MC, USA; George Pazos, MD, LCDR, MC, USN
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Abstract
Grisel's syndrome is a rare but well-documented clinical entity. It is a nontraumatic, fixed rotary subluxation of C1 on C2 (atlantoaxial). Although first described in 1830, the exact mechanism of Grisel's syndrome remains unclear. We present a postoperative case of Grisel's syndrome and an extensive literature review, and we propose a mechanism for its pathogenesis. In addition, we propose a treatment algorithm for Grisel's syndrome.

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