Os Odontoideum as a Cause of Cervical Cord Injury in a Patient with Refractory Epilepsy

Shohei Kusabiraki1 , Eiji Nakagawa1*, Takashi Saito1 , Yutaro Takayama2 , Keiya Iijima2 , Masaki Iwasaki2 , Ayano Matsui3 and Tetsuya Abe4

1 Department of Child Neurology, National Center Hospital, NCNP, Japan 2 Department of Neurosurgery, National Center Hospital, Japan 3 Department of Orthopedics, National Center Hospital, Japan 4 Department of Orthopedic Surgery, University of Tsukuba, Japan

^*Correspondance to: Eiji Nakagawa 

 PDF  Full Text DOI: 10.25107/2474-1647.3057

Abstract

Os odontoideum is an anomaly of the second cervical vertebrae in which the odontoid process is separated from the body of the axis. Traumatic injury or congenital fusion failure is thought to be the etiology. The clinical symptoms are variable from cervical pain, torticollis, and myelopathy and vertebrobasilar ischemia. Os odontoideum can cause instability of the neck, and neck injuries can cause life-threatening complications. In this report, we present the case of a 15-year-old girl with refractory epilepsy who developed quadriparesis after a fall and hit to the forehead while traveling. Although the symptoms improved, weakness in her right upper limb persisted at 2 months after the fall. Imaging studies revealed Os odontoideum. Based on her medical history, the recent head trauma due to epileptic seizures accompanied by atlantoaxial instability was considered to result in cervical compression and spinal damage. She was at a high risk of sudden death due to recurrent seizures and cervical injury; therefore, she underwent vertebral fusion surgery.

Keywords

Epilepsy; Os odontoideum; Cervical injury; Vertebral fusion surgery

Cite the article

Kusabiraki S, Nakagawa E, Saito T, Takayama Y, Iijima K, Iwasaki M, et al. Os Odontoideum as a Cause of Cervical Cord Injury in a Patient with Refractory Epilepsy. Clin Surg. 2021; 6: 3057..