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Type I Chiari malformation presenting central sleep apnea.
Auris Nasus Larynx. 2014 Apr; 41(2):222-4.AN

Abstract

Sleep apnea is a rare but a well-known clinical feature of type I Chiari malformation. It may be obstructive or central in nature. Sleep apnea in patients with type I Chiari malformation rarely presents without accompanying neurological signs or symptoms. We here report a case of a 10-year-old girl who presented with central sleep apnea without any other neurological signs but was ultimately diagnosed with type I Chiari malformation. The patient initially showed mild improvement in symptoms after administration of an acetazolamide. Finally, posterior fossa decompression dramatically improved her respiratory status during sleep, both clinically and on polysomnography. This case suggests that type I Chiari malformation should be considered in the differential diagnoses of central apneas in children, even if there are no other neurological signs and symptoms. Furthermore, sagittal craniocervical magnetic resonance imaging may be necessary for a definitive diagnosis.

Authors+Show Affiliations

Department of Sleep Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan; Department of Otorhinolaryngology, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan. Electronic address: kitamura@med.uoeh-u.ac.jp.Department of Sleep Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Nanbu-Sogo-Kenkyu-1-Goukan, Room# 513, 53 Shogoin-Kawara-cho, Sakyo-ku, Kyoto 606-8507, Japan.Department of Sleep Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.Department of Sleep Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.Tanaka Sleep Clinic, Shijo-SET-biru 5F 99 Tachiuri-Nakano-cho, Shimogyo-ku, Kyoto 600-8006, Japan.Department of Otorhinolaryngology, Social Insurance Shiga Hospital, 16-1 Fujimidai Otsu, Shiga 520-0846, Japan.Department of Neurosurgery, Fukui Red Cross Hospital, 2-4-1, Tsukimi, Fukui, Japan.Department of Otorhinolaryngology, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24161709

Citation

Kitamura, Takuro, et al. "Type I Chiari Malformation Presenting Central Sleep Apnea." Auris, Nasus, Larynx, vol. 41, no. 2, 2014, pp. 222-4.
Kitamura T, Miyazaki S, Kadotani H, et al. Type I Chiari malformation presenting central sleep apnea. Auris Nasus Larynx. 2014;41(2):222-4.
Kitamura, T., Miyazaki, S., Kadotani, H., Kanemura, T., Okawa, M., Tanaka, T., Komada, I., Hatano, T., & Suzuki, H. (2014). Type I Chiari malformation presenting central sleep apnea. Auris, Nasus, Larynx, 41(2), 222-4. https://doi.org/10.1016/j.anl.2013.07.011
Kitamura T, et al. Type I Chiari Malformation Presenting Central Sleep Apnea. Auris Nasus Larynx. 2014;41(2):222-4. PubMed PMID: 24161709.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Type I Chiari malformation presenting central sleep apnea. AU - Kitamura,Takuro, AU - Miyazaki,Soichiro, AU - Kadotani,Hiroshi, AU - Kanemura,Takashi, AU - Okawa,Masako, AU - Tanaka,Toshihiko, AU - Komada,Ichiro, AU - Hatano,Taketo, AU - Suzuki,Hideaki, Y1 - 2013/10/23/ PY - 2013/03/24/received PY - 2013/07/12/revised PY - 2013/09/20/accepted PY - 2013/10/29/entrez PY - 2013/10/29/pubmed PY - 2014/10/23/medline KW - Acetazolamide KW - Central sleep apnea KW - Children KW - Polysomnography KW - Type I Chiari malformation SP - 222 EP - 4 JF - Auris, nasus, larynx JO - Auris Nasus Larynx VL - 41 IS - 2 N2 - Sleep apnea is a rare but a well-known clinical feature of type I Chiari malformation. It may be obstructive or central in nature. Sleep apnea in patients with type I Chiari malformation rarely presents without accompanying neurological signs or symptoms. We here report a case of a 10-year-old girl who presented with central sleep apnea without any other neurological signs but was ultimately diagnosed with type I Chiari malformation. The patient initially showed mild improvement in symptoms after administration of an acetazolamide. Finally, posterior fossa decompression dramatically improved her respiratory status during sleep, both clinically and on polysomnography. This case suggests that type I Chiari malformation should be considered in the differential diagnoses of central apneas in children, even if there are no other neurological signs and symptoms. Furthermore, sagittal craniocervical magnetic resonance imaging may be necessary for a definitive diagnosis. SN - 1879-1476 UR - https://www.unboundmedicine.com/medline/citation/24161709/Type_I_Chiari_malformation_presenting_central_sleep_apnea_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0385-8146(13)00179-X DB - PRIME DP - Unbound Medicine ER -