Cervical spine abnormalities in Down Syndrome

Topic: Brain proteins, microglia and lab models

Down Syndrome (DS) is the most common of the chromosomal disorders and manifests abnormalities in several organ systems. While mental retardation, skull and brain anomalies, and the development of Alzheimer-type neuropathological changes in patients greater than age 40 years are well recognized by neurologists and neuropathologists, less appreciated are the various cervical spine abnormalities that can occur. Widening of the anterior atlanto-odontoid distance (AAOD) and atlantooccipital instability occur in up to 21% and 63% of DS patients, respectively, but neurologic complaints are uncommon and rarely are severe enough to contribute to the patient's demise. We present a case of 49-year-old DS patient whose triplegia, subacute progressive respiratory failure, and death could be attributed to severe degenerative joint disease of the cervical spine with osteophyte formation and severe spinal canal stenosis. We provide the first detailed correlation study between pre-mortem magnetic resonance imaging (MRI) and extensive autoptic dissection in an adult DS patient with cervical spine abnormalities, as well as a review of the literature.

Key findings

• Down Syndrome (DS) is the most common of the chromosomal disorders and manifests abnormalities in several organ systems.
• While mental retardation, skull and brain anomalies, and the development of Alzheimer-type neuropathological changes in patients greater than age 40 years are well recognized by neurologists and neuropathologists, less appreciated are the various cervical spine abnormalities that can occur.
• Widening of the anterior atlanto-odontoid distance (AAOD) and atlantooccipital instability occur in up to 21% and 63% of DS patients, respectively, but neurologic complaints are uncommon and rarely are severe enough to contribute to the patient's demise.
• We present a case of 49-year-old DS patient whose triplegia, subacute progressive respiratory failure, and death could be attributed to severe degenerative joint disease of the cervical spine with osteophyte formation and severe spinal canal stenosis.
• We provide the first detailed correlation study between pre-mortem magnetic resonance imaging (MRI) and extensive autoptic dissection in an adult DS patient with cervical spine abnormalities, as well as a review of the literature.

Why it matters

This case report describes a 49-year-old person with Down syndrome whose triplegia, respiratory failure and death were attributed to severe degenerative cervical spine disease. It concerns cervical spine abnormalities, not the treatment, cure or prevention of Alzheimer's disease.

Study details

• Evidence strengthLow

Read the original

• PubMed: 10505434
• Original source →

May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.

@article{frost1999-10505434,
  author  = {Frost, M. and Huffer, W. E. and Sze, C. I. and Badesch, D. and Cajade-Law, A. G. and Kleinschmidt-DeMasters, B. K.},
  title   = {{Cervical spine abnormalities in Down Syndrome}},
  journal = {Clinical neuropathology},
  year    = {1999},
  pmid    = {10505434}
}

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