Twists and turns: Unraveling unusual cervical instability in a case of prior neck infection

This case report describes a 17-year-old girl presenting with headaches, neck pain, and restricted neck movements, ultimately diagnosed with Grisel syndrome (GS) concurrent with basilar impression (BI). On initial admission, she was found to have retropharyngeal and paravertebral abscesses. Empirical treatment led to clinical recovery, but subsequent stiffness and restricted neck movements prompted further investigation. Imaging revealed rotatory atlantoaxial subluxation along with BI. This case underscores the importance of considering GS and/or BI in patients with neck infections and emphasizes early recognition and appropriate management to prevent neurological complications.