The majority of children with Down syndrome and atlantoaxial instability are symptomatic.

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Multiple Choice

The majority of children with Down syndrome and atlantoaxial instability are symptomatic.

Explanation:
Atlantoaxial instability in Down syndrome is often found on imaging, but most children with this condition do not have symptoms. The lax ligaments and possible odontoid abnormalities in Down syndrome create instability at the C1-C2 level, yet neurological signs only appear in a minority when the spinal cord or nerve roots are compressed. So the statement that the majority are symptomatic is not correct. In asymptomatic cases, monitoring and avoiding high-risk neck movements or activities is common; if symptoms develop or there is significant instability, management may include immobilization or surgical stabilization.

Atlantoaxial instability in Down syndrome is often found on imaging, but most children with this condition do not have symptoms. The lax ligaments and possible odontoid abnormalities in Down syndrome create instability at the C1-C2 level, yet neurological signs only appear in a minority when the spinal cord or nerve roots are compressed. So the statement that the majority are symptomatic is not correct. In asymptomatic cases, monitoring and avoiding high-risk neck movements or activities is common; if symptoms develop or there is significant instability, management may include immobilization or surgical stabilization.

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