Dear Editor:

We read with great interest the comprehensive review paper of Osiro et al. presenting Grisel's syndrome [1]. Apart from the introduction of this rare syndrome, the authors discussed recent developments on the pathogenesis of the syndrome along with treatment options. In the introduction, Sir Charles Bell (1774–1842 CE) was introduced as the first to explain nontraumatic atlantoaxial subluxation due to pharyngitis which ultimately led to death of the patient from spinal cord compression [1, 2]. Grisel's syndrome was named after Pierre Grisel (1869–1959 CE), a French surgeon who described the syndrome characterized by dislocation of the C1–C2 joint mostly in patients with pharyngitis and torticollis [1, 3]. Based on the historical evidence, we believe that the syndrome was known to the Greek and Persian physicians much earlier than thought. Among the ancient Greek scholars, Aëtius of Amida (fifth–sixth century of the Common Era) seems to be the first to indicate the association between inflammation of the vertebrae caused by retropharyngeal abscess and vertebral luxation in his section on diphtheria [4]. The syndrome was later described by Rhazes (865–925 CE) in his Kitab al-Hawi (Liber Continens) quoting from Hippocrates' Of The Epidemics [5].

In the tenth century of the Common Era, Akhawayni Bukhari (Fig. 1), a prominent Persian physician, compiled the oldest extant treatise on medicine in new Persian, Hidayat al-Muta`allemin fi al-Tibb (The Students' Handbook of Medicine) [6, 7]. Being relatively short and simplified, the Hidayat was dedicated to the author's son and other students of medicine [8]. The second part of the book contains a chapter on the diphtheria describing different etiologies of suffocation, with a particular emphasis on a complication associated with neck pain and anterior subluxation of the cervical vertebrae. In addition to his description of this clinical entity, Akhawayni recommends novel life-saving approaches to the disease. Briefly, he advised application of either tongs or especially designed reins for applying pressure to reduce the subluxated vertebra [9]. The disease appears in the medical writings of the following centuries such as Avicenna's The Canon of Medicine and Jorjani's The Treasure of Khwarazm Shah, none of which have discussed the disease as detailed and instructive as that of Akhawayni's [10–12].

Fig. 1
figure 1

An imaginary portrait of Akhawayni Bukhari (?-983 CE) (by an artist, Ramin Abdollahzadeh)

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Altogether, descriptions of Grisel's syndrome and its associated symptoms are not limited to the recent centuries and date back to the earlier periods.