PEDIATRICS Vol. 85 No. 3 March 1990, pp. 447-449
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Symptomatic Atlantoaxial Instability Associated With Medical and Rehabilitative Procedures in Children With Down Syndrome

Michael E. Msall MD1, Mary E. Reese MD1, Kathleen DiGaudio RN, MS, PNP1, Kim Griswold RN, MPH1, Carl V. Granger MD1, and Robert E. Cooke MD1

1 From the Division of Developmental Pediatrics, Rehabilitation and Developmental Disabilities, Robert Warner Rehabilitation Center, Children's Hospital of Buffalo, State University of New York at Buffalo, School of Medicine and Biomedical Sciences

The Canadian College of Medical Genetics recently questioned the rationale for radiographic screening for atlantoaxial instability in Down syndrome. We report a case series of four children with Down syndrome with symptomatic atlantoaxial instability and followed for more than 5 years. In all cases a medical or rehabilitational procedure was associated with significant apnea, cardiopulmonary compromise, or severe neurological impairments. None of these patients were screened radiographically. The need for protocols to detect atlantoaxial instability in children with Down syndrome undergoing medical and rehabilitational procedures is highlighted by these cases.

Key Words: Down syndrome • atlantoaxial instability




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 Arch Pediatr Adolesc MedHome page
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Arch Pediatr Adolesc Med, February 1, 1998; 152(2): 119 - 122.
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