Bulbar symptoms and episodic aphonia associated with atlanto-occipital subluxation in ankylosing spondylitis.

A patient with intermittent aphonia associated with atlanto-occipital subluxation due to ankylosing spondylitis is presented and discussed. The only other case from the literature is reviewed and compared with our patient, where symptoms and signs of episodic low bulbar disease, presumably due to intermittent vascular insufficiency, were relieved by external bracing.