Multifactorial obstructive sleep apnea in a patient with Chiari malformation.
We report a patient with severe obstructive sleep apnea (OSA) associated with a unique combination of syringobulbia-myelia, Chiari malformation type I (CM), absent hypoxic ventilatory drive, vocal cord paralysis, post-menopausal status, obesity, and acute respiratory failure necessitating mechanical ventilation. The remote onset of OSA five years after surgery underscores the need for long-term follow-up of patients with syringobulbia-myelia and CM and the importance of addressing multiple interacting neurologic, metabolic, and mechanical predispositions to sleep-disordered breathing.
Section on Pulmonary and Critical Care Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1054.
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McCall
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Haponik
D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008526:Medulla Oblongata / Q000473:pathology; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D017698:Postmenopause; D012120:Respiration Disorders / Q000150:complications; D012891:Sleep Apnea Syndromes / Q000150:complications*; D013595:Syringomyelia / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D014826:Vocal Cord Paralysis / Q000150:complications