A case report of atlanto-axial instability in a Down Syndrome patient

INTRODUCTION: Down Syndrome (DS)—also referred to as Trisomy 21—is associated with multiple deformities affecting various systems of the body. Joint laxity resulting in unstable atlanto-occipital and atlanto-axial joints—with an increased susceptibility to fatal cord injuries—is a recognized phenomenon in patients with DS. CASE PRESENTATION: We report on a 30-year-old man with DS from Tanzania with no previous neck complaints, who presented with a 5-week progressive history of paraparesis that evolved into a quadriparesis. During his initial presentation, the patient reported that 5 months ago he had been involved in a headlock during a playground encounter. DISCUSSION: Primary prevention of the traumatic spinal cord injuries is an important public health measure and a heightened emphasis should be placed to prevent such injuries in high risk populations—including DS patients.