Grisel's syndrome: a case of potentially lethal spinal cord injury in the adult

A 22-year-old woman presented with respiratory difficulty and quadriparesis two weeks after an upper respiratory tract infection. CT showed mild (Type I) rotatory atiantoaxial subluxation, but MRI demonstrated a severely contused and oedematous spinal cord at C2-3. The case was managed conservatively with collar, steroid and antibiotics. The outcome was excellent.