Grisel's disease is a pathology accompanied by inflammation and shortening of the muscles of the neck on one side. This ailment is also called Grisell's torticollis or spondylitis of the upper cervical spine. The inflammatory process in the muscles develops as a complication of infectious diseases of the nasopharynx, pharynx, or lymph nodes. Most often, children suffer from this disease. What are the symptoms of this pathology? And how to cure her? We will consider these issues in the article.
What it is
With Grisel disease, the patient develops muscle contracture in the region of the first cervical vertebra. As a result, the muscles lose their ability to contract and stretch. Such a violation develops only after infectious diseases:
- tonsillitis;
- rhinopharyngitis;
- sore throats;
- tonsil abscess;
- purulent arthritis of the cervical vertebrae;
- inflammation of the lymph nodes in the throat.
Grisel disease in children most often occurs between the ages of 6 and 11 years. Girls are more susceptible to this pathology.
Mechanism of occurrence
How does such a complication develop after infections? Inflammation passes from the throat to the pharyngeal lymph node. Further, it extends to the muscles attached to the first cervical vertebra. It is this muscle group that is responsible for the movements of the neck and head. In the future, the muscles are shortened, and the cervical vertebra shifts. This leads to the appearance of torticollis.
Muscle inflammation in Grisel disease has an infectious etiology. However, such a complication after suffering tonsillitis or rhinopharyngitis is not observed in all patients. Doctors suggest that people with weak neck ligaments are especially prone to this disease.
ICD code
According to the International Classification of Disease, Grizzel torticollis belongs to deforming dorsopathies. So-called pathologies, accompanied by pain in the back and neck due to displacement of the vertebrae. The complete code of Grisel disease according to ICD-10 is M43.6.
Symptomatology
Usually torticollis develops after the disappearance of acute manifestations of infectious diseases. The first sign of pathology is an increase in temperature and a deterioration in overall well-being. Then the following symptoms of torticollis occur:
- The head of the patient takes an unnatural position. She is constantly leaning in one direction.
- The patient is able to bend and unbend his neck to the side of the slope, but cannot rotate his head.
- Severe pain appears on the affected side of the neck, which intensifies with movements.
Most often, signs of torticollis appear in the morning. Some patients experience headache, dizziness, fear of light, double vision.
Diagnostics
A neurologist is involved in diagnosing Grisel disease. When examining a patient, a specialist performs palpation of the neck. In patients, muscle relaxation is determined on the side of the head tilt, and muscle tension on the healthy side. The protruding second vertebra of the neck is also palpated.
The patient also needs an otolaryngologist's consultation, as the cause of Grisel's torticollis is an ear, nose and throat disease.
An X-ray of the cervical region helps to make the final diagnosis. In the picture, you can notice the displacement and rotation of the first vertebra around its axis.
Treatment
To get rid of Grizzle torticollis, it is necessary to treat the underlying disease. Patients are prescribed a course of antibiotic therapy and ultraviolet irradiation of the primary focus of inflammation.
An effective treatment for Grisel disease is to apply a Glisson loop. This device is a construction of straps and braces to support the cervical spine. The loop is attached to a special simulator with a load. The patient is offered to turn his head and do various exercises. In this case, the patient has to overcome the load resistance. This therapy helps to stretch the spine and eliminate torticollis.
At the same time, electrophoresis with calcium iodide is prescribed. After a course of procedures, muscle tightening in the affected area gradually resolves.
After the deformation disappears, the patient is recommended to wear a special collar made of plaster. This helps to fix the muscles in the correct position. Use this device for about 3 weeks.
After a full recovery, a course of exercise therapy and massage is prescribed. The duration of treatment depends on the degree of deformation.
Forecast
If Grisel disease was diagnosed in time in a child, then the prognosis is usually favorable. After the course of treatment, the signs of torticollis completely disappear. The muscles become mobile again and the neck returns to its normal position.
In adult patients, such a disease is much more difficult to treat. Often, even after a course of therapy, the consequences of the pathology persist: deformations of the skull or face, as well as curvature of the spine. Therefore, at the first signs of torticollis after an infection, you must consult a neurologist.