title: Nocturnal apnea in Chiari type I malformation.
abstract: A 4-year-old girl presented with sleep-disordered breathing. Her parents described breathing pauses of up to 20 s and progressive tiredness during the day. Obstructive apneas from an enlarged adenoid were thought to be the most probable cause. However, an adenotomy did not resolve the problem. Polysomnography demonstrated central apneas, and cerebral magnetic resonance imaging revealed a Chiari type I malformation. We describe the differential diagnosis of apnea in children and the role of polysomnography in the distinction between obstructive and central apneas.
  
  
  CONCLUSIONS
  This case illustrates that, in children with apnea, it is important to consider central causes as well as the more common obstructive causes, even in the absence of additional neurological signs or symptoms.
authors.affiliation: Department of Pediatrics, Máxima Medical Centre, Veldhoven Postbus 7777, 5500 MB Veldhoven, the Netherlands. Lonneke.Aarts@mmc.nl
authors.forename: Lonneke A M
authors.initials: LA
authors.lastname: Aarts
authors.forename: Michèl A A P
authors.initials: MA
authors.lastname: Willemsen
authors.forename: Nele L E
authors.initials: NL
authors.lastname: Vandenbussche
authors.forename: René
authors.initials: R
authors.lastname: van Gent
mesh_terms: D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000175:diagnosis*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D017286:Polysomnography; D020182:Sleep Apnea, Central / Q000175:diagnosis* / Q000209:etiology*