Frequently Asked Questions

CAN WE PREDICT WHICH PEOPLE ARE LIKELY TO HAVE PROBLEMS DUE TO ATLANTO-AXIAL INSTABILITY?  No we cannot predict AAI.

What should we be mindful of?
Sudden neck dislocation is very rare in Down syndrome.  We do know that mild symptoms occur in most people before the dislocation occurs, so it is important to be aware of the symptoms.

What treatment is available?
If atlanto-axial instability is suspected your child may be referred to either a neurologist or a spinal orthopaedic surgeon. If instability or dislocation is confirmed and is causing problems an operation may be required.

Should my child participate in sports?
Children with Down syndrome should not be barred from sporting activities because there is no evidence that participation in sports increases the risk of cervical spine injury any more than for the general population.

Further Reading:
Atlanto-Axial Instability among people with Down syndrome – Notes for Parents by Dr J Dennis DSMIG 2001 DSA
Guidelines for the Medical Management of Irish Children and Adolescents with Down Syndrome, Irish Medical Journal, Feb 2005, Vol 98 No 2; 48-52.  Murphy J, Hoey HMCV, Philip M, Roche EF, Macken S, Mayne P, Duff D, O’Keefe M, McShane D, Fogarty E, O’Regan M.

Written by Dr. Joan Murphy PhD, Clinical/Research Nurse Specialist, Dept of Paediatrics, Trinity College Dublin, National Children’s Hospital, AMNCH, Tallaght, Dublin 24. Clinical Co-ordinator for Down Syndrome Ireland.