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A case of Arnold-Chiari Type I malformation presenting with dysrhythmic breathing during sleep.
Psychiatry Clin Neurosci. 1998 Apr; 52(2):212-6.PC

Abstract

A 43-year-old woman presented with dull headache, left tinnitus and dizziness. Neurological examination revealed down-beat gaze nystagmus, left tinnitus, positive Romberg sign, poor standing on the left foot, poor tandem gait, left spastic gait and positive pathological reflexes in the bilateral upper and lower extremities. Plain X-ray of the skull and cervical vertebrae demonstrated basilar impression and atlantoaxial fusion. Magnetic resonance imaging of the brain and cervical spine showed cerebellar tonsil descent and syringomyelia located in the left side of the spine at the II-III vertebral level which communicated with the fourth ventricle. The patient was diagnosed as having cervical syringomyelia. Arnold-Chiari type I malformation and basilar impression. Preoperative polysomnography showed dysrhythmic breathing and bradypnea during sleep. Abnormal breathing improved after suboccipital decompression craniotomy and upper cervical laminectomy. It was suggested that dysrhythmic breathing was caused by a disorder of the medullary respiratory center. Herniation of the cerebellar tonsil and syringomyelia might have compressed the medulla.

Authors+Show Affiliations

Department of Neurology, Dokkyo University, School of Medicine, Tochigi, Japan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

9628158

Citation

Miyamoto, M, et al. "A Case of Arnold-Chiari Type I Malformation Presenting With Dysrhythmic Breathing During Sleep." Psychiatry and Clinical Neurosciences, vol. 52, no. 2, 1998, pp. 212-6.
Miyamoto M, Miyamoto T, Hirata K, et al. A case of Arnold-Chiari Type I malformation presenting with dysrhythmic breathing during sleep. Psychiatry Clin Neurosci. 1998;52(2):212-6.
Miyamoto, M., Miyamoto, T., Hirata, K., & Katayama, S. (1998). A case of Arnold-Chiari Type I malformation presenting with dysrhythmic breathing during sleep. Psychiatry and Clinical Neurosciences, 52(2), 212-6.
Miyamoto M, et al. A Case of Arnold-Chiari Type I Malformation Presenting With Dysrhythmic Breathing During Sleep. Psychiatry Clin Neurosci. 1998;52(2):212-6. PubMed PMID: 9628158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A case of Arnold-Chiari Type I malformation presenting with dysrhythmic breathing during sleep. AU - Miyamoto,M, AU - Miyamoto,T, AU - Hirata,K, AU - Katayama,S, PY - 1998/6/17/pubmed PY - 1998/6/17/medline PY - 1998/6/17/entrez SP - 212 EP - 6 JF - Psychiatry and clinical neurosciences JO - Psychiatry Clin Neurosci VL - 52 IS - 2 N2 - A 43-year-old woman presented with dull headache, left tinnitus and dizziness. Neurological examination revealed down-beat gaze nystagmus, left tinnitus, positive Romberg sign, poor standing on the left foot, poor tandem gait, left spastic gait and positive pathological reflexes in the bilateral upper and lower extremities. Plain X-ray of the skull and cervical vertebrae demonstrated basilar impression and atlantoaxial fusion. Magnetic resonance imaging of the brain and cervical spine showed cerebellar tonsil descent and syringomyelia located in the left side of the spine at the II-III vertebral level which communicated with the fourth ventricle. The patient was diagnosed as having cervical syringomyelia. Arnold-Chiari type I malformation and basilar impression. Preoperative polysomnography showed dysrhythmic breathing and bradypnea during sleep. Abnormal breathing improved after suboccipital decompression craniotomy and upper cervical laminectomy. It was suggested that dysrhythmic breathing was caused by a disorder of the medullary respiratory center. Herniation of the cerebellar tonsil and syringomyelia might have compressed the medulla. SN - 1323-1316 UR - https://www.unboundmedicine.com/medline/citation/9628158/A_case_of_Arnold_Chiari_Type_I_malformation_presenting_with_dysrhythmic_breathing_during_sleep_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1323-1316&date=1998&volume=52&issue=2&spage=212 DB - PRIME DP - Unbound Medicine ER -