C1-C2 SUBLUXTION WITH AN ASSOCIATED ARNOLD CHIARI MALFORMATION PRESENTING AS SPASMODIC TORCICOLLIS. A 1-YEAR FOLLOW UP CASE REPORT

Torticollis in children has different causes and a persistent twisted neck position should always be more closely investigated. Prior the introduction of Magnetic Resonance Imaging and Computed Tomography scanning the diagnosis of atlantoaxial rotatory fixation was based on conventional X-ray examination. Atlantoaxial rotatory subluxation is a rare condition and in our patient it was associated with an Arnold–Chiari malformation, a condition affecting the brain consisting of a downward displacement of the cerebellar tonsils through the foramen magnum. In the report we present a case, communicating of a late-diagnosed atlantoaxial subluxation in 8 years old child reporting clinical presentation with radiological findings of a C1-C2 subluxation associated to an Arnold Chiari M. and a summary description of rehabilitation approach. The attempts to reduce subluxation and improve movement were fortunately successful thanks to traction, physiotherapy and muscle relaxant even if atlantoaxial rotatory fixation persisted for more than 2 – 3 months.