Extract
Atlantoaxial subluxation is a rare but well-recognized complication
of ankylosing
spondylitis1-7.
Anterior subluxation is most common, but vertical subluxation of the dens may
also occur and may result in cervical myelopathy, lower cranial nerve palsy,
or even sudden death due to cervicomedullary
compression8-10.
Tongue paralysis due to isolated hypoglossal nerve palsy is also
rare11-13.
In addition to occurring in patients with rheumatoid
arthritis14,15,
hypoglossal nerve palsy has been noted in association with a number of
pathological conditions such as occipital condylar fracture, metastatic tumor
in the skull base, and
infection16. We
report on a patient with ankylosing spondylitis who presented with
life-threatening atlantoaxial rotatory dislocation and bilateral hypoglossal
nerve palsy and was successfully treated with halo-dependent traction followed
by occipitocervical arthrodesis. To the best of our knowledge, bilateral
hypoglossal nerve palsy with tongue paralysis arising from atlantoaxial
rotatory dislocation has never been reported in a patient with ankylosing
spondylitis. The patient consented to have the data concerning the case
submitted for publication.