Ann Rehabil Med.  2011 Dec;35(6):934-938. 10.5535/arm.2011.35.6.934.

Collet-Sicard Syndrome in a Patient with Jefferson Fracture

• Kwon HC
• Cho DK
• Jang YY
• Lee SJ
• Hyun JK
• Kim TU

• KMID: 2266821
• DOI: http://doi.org/10.5535/arm.2011.35.6.934

Abstract

Collet-Sicard syndrome is a rare condition characterized by the unilateral paralysis of the 9th through 12th cranial nerves. We describe a case of a 46-year-old man who presented with dysphagia after a falling down injury. Computed tomography demonstrated burst fracture of the atlas. Physical examination revealed decreased gag reflex on the left side, decreased laryngeal elevation, tongue deviation to the left side, and atrophy of the left trapezius muscle. Videofluoroscopic swallowing study (VFSS) revealed frequent aspirations of a massive amount of thick liquid and incomplete opening of the upper esophageal sphincter during the pharyngeal phase. We report a rare case of Collet-Sicard syndrome caused by Jefferson fracture.

Keyword

Collet-Sicard syndrome; Jefferson fracture; Cranial nerve injury

MeSH Terms

Aspirations (Psychology)
Atrophy
Cranial Nerve Injuries
Cranial Nerves
Deglutition
Deglutition Disorders
Esophageal Sphincter, Upper
Humans
Middle Aged
Muscles
Paralysis
Physical Examination
Reflex
Tongue

Figure

• 

  Fig. 1 (A) Computed tomography scan reveals a Jefferson fracture. Fracture line of C1 spine (arrows) was extended to the left side transverse foramen. (B) Cervical spine lateral view show C1-C3 spine fixation and fusion using screw.

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  Fig. 2 Videofluoroscopic swallowing study shows incomplete upper esophageal sphincter opening (arrow) at the beginning of esophageal phase (A) and tracheal aspiration (B, black arrow) and significant vallecular and piriformis retension (B, white arrow). On day 57 of admission, the study reveal improved incomplete upper esophageal sphincter opening (C, arrow).

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  Fig. 3 The patient shows atrophy of left upper trapezius muscle (thick arrow) (A), and winged scapula on horizontal abduction (thin arrow) (B).

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  Fig. 4 (A) The tongue deviates to the left side on protrusion. (B) On day 50, there is no deviation of the tongue on protrusion.

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