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Acute respiratory failure and sleep-disordered breathing in Arnold-Chiari malformation.
Clin Neurol Neurosurg. 2005 Oct; 107(6):521-4.CN

Abstract

We report on the case of a 32-year-old man who was admitted after an episode of acute respiratory failure. Clinical and laboratory investigations revealed nocturnal hypoventilation with predominately obstructive sleep apneas accompanied by lower cranial nerve palsies, cerebellar and mild pyramidal signs. Magnetic resonance imaging disclosed Arnold-Chiari type I malformation with syringomyelia. Transcranial magnetic stimulation demonstrated the integrity of the corticodiaphragmatic pathway and it was postulated that the respiratory disorder was mainly due to the severe and irreversible lower cranial nerve palsies. Two years after decompressive craniectomy, sleep disordered-breathing persisted despite no radiological evidence of brain stem compression. Nevertheless, non-invasive positive pressure ventilation (NIPPV) during sleep proved to be quite effective in the management of the patient's refractory respiratory insufficiency. In conclusion, Arnold-Chiari type I may rarely present with acute respiratory failure and sleep apneas. An electrophysiological investigation into the mechanism of the respiratory dysfunction is presented.

Authors+Show Affiliations

Second Chest Department of Aristotle University, School of Medicine, George Papanikolaou Hospital, Thessaloniki, Greece.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

16202827

Citation

Tsara, Venetia, et al. "Acute Respiratory Failure and Sleep-disordered Breathing in Arnold-Chiari Malformation." Clinical Neurology and Neurosurgery, vol. 107, no. 6, 2005, pp. 521-4.
Tsara V, Serasli E, Kimiskidis V, et al. Acute respiratory failure and sleep-disordered breathing in Arnold-Chiari malformation. Clin Neurol Neurosurg. 2005;107(6):521-4.
Tsara, V., Serasli, E., Kimiskidis, V., Papagianopoulos, S., Katsaridis, V., Fylaktakis, M., Christaki, P., & Kazis, A. (2005). Acute respiratory failure and sleep-disordered breathing in Arnold-Chiari malformation. Clinical Neurology and Neurosurgery, 107(6), 521-4.
Tsara V, et al. Acute Respiratory Failure and Sleep-disordered Breathing in Arnold-Chiari Malformation. Clin Neurol Neurosurg. 2005;107(6):521-4. PubMed PMID: 16202827.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute respiratory failure and sleep-disordered breathing in Arnold-Chiari malformation. AU - Tsara,Venetia, AU - Serasli,Eva, AU - Kimiskidis,Vassilios, AU - Papagianopoulos,Sotirios, AU - Katsaridis,Vassilios, AU - Fylaktakis,Makedos, AU - Christaki,Pandora, AU - Kazis,Aristidis, PY - 2003/08/01/received PY - 2004/09/02/revised PY - 2004/10/12/accepted PY - 2005/10/6/pubmed PY - 2006/1/7/medline PY - 2005/10/6/entrez SP - 521 EP - 4 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 107 IS - 6 N2 - We report on the case of a 32-year-old man who was admitted after an episode of acute respiratory failure. Clinical and laboratory investigations revealed nocturnal hypoventilation with predominately obstructive sleep apneas accompanied by lower cranial nerve palsies, cerebellar and mild pyramidal signs. Magnetic resonance imaging disclosed Arnold-Chiari type I malformation with syringomyelia. Transcranial magnetic stimulation demonstrated the integrity of the corticodiaphragmatic pathway and it was postulated that the respiratory disorder was mainly due to the severe and irreversible lower cranial nerve palsies. Two years after decompressive craniectomy, sleep disordered-breathing persisted despite no radiological evidence of brain stem compression. Nevertheless, non-invasive positive pressure ventilation (NIPPV) during sleep proved to be quite effective in the management of the patient's refractory respiratory insufficiency. In conclusion, Arnold-Chiari type I may rarely present with acute respiratory failure and sleep apneas. An electrophysiological investigation into the mechanism of the respiratory dysfunction is presented. SN - 0303-8467 UR - https://www.unboundmedicine.com/medline/citation/16202827/Acute_respiratory_failure_and_sleep_disordered_breathing_in_Arnold_Chiari_malformation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(04)00155-6 DB - PRIME DP - Unbound Medicine ER -