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Sleep disordered breathing in children and adolescents with Chiari malformation type I.
J Clin Sleep Med. 2013 Apr 15; 9(4):371-7.JC

Abstract

STUDY OBJECTIVES

Chiari malformation Type I (CM-I) has been associated with sleep disordered breathing (SDB). The aim of this study was to evaluate the prevalence of SDB in CM-I and its clinical correlates in a population of children and adolescents.

METHODS

Fifty-three consecutive children and adolescents affected by CM-I were enrolled (27 girls and 26 boys, mean age 10.3 ± 4.3, range: 3-18 years). All patients underwent neurological examination, MRI, and polysomnography (PSG). Otorhinolaryngologic clinical evaluation was performed in patients with polysomnographic evidence of sleep-related upper airway obstruction.

RESULTS

Mean size of the herniation was 9.5 ± 5.4 mm. Fourteen patients had syringomyelia, 5 had hydrocephalus, 31 presented neurological signs, 14 had epileptic seizures, and 7 reported poor sleep. PSG revealed SDB in 13 subjects. Patients with SDB, compared to those without SDB, had a higher prevalence hydrocephalus (p = 0.002), syringomyelia (p = 0.001), and neurological symptoms (p = 0.028). No significant difference was observed in age, gender, prevalence of epilepsy, and size of the herniation. Obstructive SDB was associated with syringomyelia (p = 0.004), whereas central SDB was associated with hydrocephalus (p = 0.034).

CONCLUSIONS

In our population of CM-I patients the prevalence of SDB was 24%, lower than that reported in literature. Moreover, our findings suggest that abnormalities in cerebrospinal fluid dynamics in CM-I, particularly syringomyelia and hydro-cephalus, are associated with SDB.

Authors+Show Affiliations

Institute of Neurology, Catholic University, Rome, Italy. annalosurdo@hotmail.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23585753

Citation

Losurdo, Anna, et al. "Sleep Disordered Breathing in Children and Adolescents With Chiari Malformation Type I." Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, vol. 9, no. 4, 2013, pp. 371-7.
Losurdo A, Dittoni S, Testani E, et al. Sleep disordered breathing in children and adolescents with Chiari malformation type I. J Clin Sleep Med. 2013;9(4):371-7.
Losurdo, A., Dittoni, S., Testani, E., Di Blasi, C., Scarano, E., Mariotti, P., Paternoster, G., Di Rocco, C., Massimi, L., & Della Marca, G. (2013). Sleep disordered breathing in children and adolescents with Chiari malformation type I. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, 9(4), 371-7. https://doi.org/10.5664/jcsm.2592
Losurdo A, et al. Sleep Disordered Breathing in Children and Adolescents With Chiari Malformation Type I. J Clin Sleep Med. 2013 Apr 15;9(4):371-7. PubMed PMID: 23585753.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sleep disordered breathing in children and adolescents with Chiari malformation type I. AU - Losurdo,Anna, AU - Dittoni,Serena, AU - Testani,Elisa, AU - Di Blasi,Chiara, AU - Scarano,Emanuele, AU - Mariotti,Paolo, AU - Paternoster,Giovanna, AU - Di Rocco,Concezio, AU - Massimi,Luca, AU - Della Marca,Giacomo, Y1 - 2013/04/15/ PY - 2013/4/16/entrez PY - 2013/4/16/pubmed PY - 2013/11/5/medline KW - Chiari malformation KW - central sleep apnea KW - hydrocephalus KW - obstructive sleep apnea KW - polysomnography KW - sleep disordered breathing KW - syringomyelia. SP - 371 EP - 7 JF - Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine JO - J Clin Sleep Med VL - 9 IS - 4 N2 - STUDY OBJECTIVES: Chiari malformation Type I (CM-I) has been associated with sleep disordered breathing (SDB). The aim of this study was to evaluate the prevalence of SDB in CM-I and its clinical correlates in a population of children and adolescents. METHODS: Fifty-three consecutive children and adolescents affected by CM-I were enrolled (27 girls and 26 boys, mean age 10.3 ± 4.3, range: 3-18 years). All patients underwent neurological examination, MRI, and polysomnography (PSG). Otorhinolaryngologic clinical evaluation was performed in patients with polysomnographic evidence of sleep-related upper airway obstruction. RESULTS: Mean size of the herniation was 9.5 ± 5.4 mm. Fourteen patients had syringomyelia, 5 had hydrocephalus, 31 presented neurological signs, 14 had epileptic seizures, and 7 reported poor sleep. PSG revealed SDB in 13 subjects. Patients with SDB, compared to those without SDB, had a higher prevalence hydrocephalus (p = 0.002), syringomyelia (p = 0.001), and neurological symptoms (p = 0.028). No significant difference was observed in age, gender, prevalence of epilepsy, and size of the herniation. Obstructive SDB was associated with syringomyelia (p = 0.004), whereas central SDB was associated with hydrocephalus (p = 0.034). CONCLUSIONS: In our population of CM-I patients the prevalence of SDB was 24%, lower than that reported in literature. Moreover, our findings suggest that abnormalities in cerebrospinal fluid dynamics in CM-I, particularly syringomyelia and hydro-cephalus, are associated with SDB. SN - 1550-9397 UR - https://www.unboundmedicine.com/medline/citation/23585753/Sleep_disordered_breathing_in_children_and_adolescents_with_Chiari_malformation_type_I_ L2 - https://doi.org/10.5664/jcsm.2592 DB - PRIME DP - Unbound Medicine ER -