A lethal case of atlantoaxial dislocation in a 56-year-old woman with Down's syndrome.

Doctors wrote up one tragic case. A 56-year-old woman with Down's died after her top neck bones slipped out of place.

The report shows how quickly the injury turned deadly. It warns that this problem can hide in adults with Down's.

The woman had neck pain for weeks. No one took pictures of her spine until she suddenly stopped breathing.

By then the bone shift had pinched her spinal cord. She could not be saved.

Sisson et al. (1993) looked at many adults with Down's in a large facility. They found risky neck spacing in four of every ten people, yet most had no pain.

That study said routine X-rays were not needed unless the person hurt. The 1995 death sounds like it clashes with that advice, but it does not.

The earlier paper studied younger facility residents who showed no signs. The 1995 paper shows what can happen when signs are ignored in mid-life.

Davis et al. (1994) and Davis et al. (1994) issued the same warning for other hidden problems: check for stroke and for late-onset mania when behavior changes.

You may see adults with Down's who rub their necks, move more slowly, or seem off balance. Do not write it off as "just Down's." Ask for a cervical X-ray the same day. Quick pictures can turn a possible fatality into a treatable injury.