Grisel's syndrome caused by Mycoplasma pneumoniae infection: a case report and review of the literature

Raffaele Falsaperla, Gianluca Piattelli, Silvia Marino, Simona Domenica Marino, Alessandra Fontana, Piero Pavone

Research output: Contribution to journalReview articlepeer-review


BACKGROUND: Grisel's syndrome is a non-traumatic subluxation of the atlantoaxial joints, which is caused by an inflammatory process involving the upper neck. Torticollis, neck pain, and reduced neck mobility are the main clinical signs of presentation. Predisposing factors are trauma, hyperlaxity of the transverse and alar ligaments of the atlantoaxial joints, and surgical interventions carried out in this area. Several viral and bacterial pathogens have been reported as causative events of Grisel's syndrome, including Epstein-Barr virus, Kawasaki disease, Streptococcus pyogenes, Staphylococcus aureus, and other infectious agents. Grisel's syndrome linked to Mycoplasma pneumoniae infection as the trigger has not previously been reported. Mycoplasma pneumoniae is a small prokaryotic microbe and a frequent etiologic factor of respiratory tract infections and, less frequently, of extrapulmonary body organs. The recognition of the Grisel's syndrome is based on clinical and neuroradiological investigations, and early diagnosis and specific treatment are crucial to the successful outcome of the disease.

RESULTS: We report the case of an 8-year-old girl with Grisel's syndrome caused by an upper respiratory tract infection due to Mycoplasma pneumoniae. Diagnostic suspicion and treatment of Grisel's syndrome were established quickly by anamnestic and clinical data and confirmed by radiological findings. The girl was immediately treated with specific antibiotic therapy and cervical immobilization, thus preventing the most dangerous complications of the disorder.

CONCLUSION: Mycoplasma pneumoniae, among the other infectious agents, may be cause of scute torticollis and Gresel's syndrome.

Original languageEnglish
Pages (from-to)523-527
Number of pages5
JournalChild's Nervous System
Issue number3
Publication statusPublished - Mar 2019


  • Atlanto-Axial Joint/pathology
  • Child
  • Female
  • Humans
  • Joint Dislocations/etiology
  • Mycoplasma pneumoniae
  • Neck Pain/etiology
  • Pneumonia, Mycoplasma/complications
  • Torticollis/etiology


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