Das Grisel-Syndrom – häufiger als gedacht?

Zusammenfassung

Das Grisel-Syndrom ist eine seltene, aber potenziell schwerwiegende Komplikation nach Infektionen oder chirurgischen Eingriffen im HNO-Bereich. Es betrifft vorwiegend Kinder im Alter von 6 bis 12 Jahren. Erstmals 1930 von Pierre Grisel beschrieben, beruht seine Pathophysiologie auf dem Zusammenspiel einer infektionsbedingten Entzündung und einer erhöhten ligamentären Laxität der kindlichen Halswirbelsäule. Etwa 60% der Fälle treten nach Infektionen der oberen Atemwege auf, 40% nach HNO-Eingriffen – insbesondere nach Adenotonsillektomien. Klinisch zeigt sich das Syndrom typischerweise mit schmerzhaftem Torticollis und eingeschränkter Kopfbeweglichkeit, in fortgeschrittenen Fällen auch mit neurologischen Symptomen. Eine frühzeitige klinische und radiologische Diagnosestellung ist entscheidend, um eine adäquate Therapie einzuleiten. In der Regel erfolgt die Behandlung konservativ mit Schmerzmitteln, entzündungshemmender Medikation und ggf. Antibiotikagabe. Eine chirurgische Stabilisierung ist bei verzögerter Diagnose, Therapieversagen oder schwerer Subluxation erforderlich. Die Kenntnis der klinischen Symptomatik ist essenziell, um rechtzeitig intervenieren zu können und schwere neurologische Komplikationen oder Funktionseinschränkungen zu vermeiden.

Abstract

Grisel’s syndrome is a rare but potentially serious complication following infections or surgical procedures in the ENT region, predominantly affecting children aged 6 to 12 years. First described by Pierre Grisel in 1930 and later systematically documented in pediatric cases, its pathophysiology involves an interplay of infection-induced inflammation and inherent ligamentous laxity of the pediatric cervical spine. Epidemiological data indicate that approximately 60% of cases occur following upper respiratory tract infections, and 40% occur after ENT surgeries, particularly adenotonsillectomy. Clinically, the syndrome typically presents with painful torticollis and limited cervical mobility, with neurological symptoms possible in advanced cases. Early clinical and radiological diagnosis is key to initiating appropriate treatment. Most cases are managed conservatively with immobilization, anti-inflammatory medication, and antibiotics when indicated. Surgical stabilization is reserved for cases with delayed diagnosis, failure of conservative treatment, or severe subluxation. Increased clinical awareness is crucial for enabling timely intervention and reducing the risk of neurological sequelae or functional impairment.

Schlüsselwörter

Grisel-Syndrom - Torticollis - Atlantoaxiale Subluxation - Halswirbelsäule

Keywords

Grisel’s syndrome - torticollis - atlantoaxial subluxation - cervical spine

Publication History

Article published online:
20 October 2025

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