Positional dysphagia secondary to a Chiari I malformation.
We describe a previously unreported phenomenon: positional dysphagia secondary to a Chiari I malformation. A 38-year-old woman presented with progressive dysphagia and cough. Flexible endoscopic evaluation of swallowing detected severe pharyngeal dysphagia and aspiration, as well as an intermittent cough reflex with all consistencies in the upright position. Various compensatory strategies were attempted to relieve the aspiration, but only assumption of the supine position was successful. Subsequent magnetic resonance imaging detected a herniation of the cerebellar tonsils to the level of C2 and the presence of a cervical syrinx-findings consistent with a Chiari I malformation. After surgical decompression of the malformation, the patient's symptoms completely resolved.
White
David L
DL
Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Rees
Catherine J
CJ
Butler
Susan G
SG
Tatter
Stephen B
SB
Markley
Lisa W
LW
Cartwright
Michael S
MS
D000328:Adult; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000175:diagnosis; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D003680:Deglutition Disorders / Q000209:etiology*; D004724:Endoscopy / Q000379:methods; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D011187:Posture