title: Chiari malformation and central sleep apnoea: successful therapy with adaptive pressure support servo-ventilation following surgical treatment.
abstract: Sleep apnoea is a common disorder with significant morbidity. It is categorised into obstructive and central sleep apnoea. There are a variety of conditions associated with central sleep apnoea ranging from cardiac failure to structural brain anomalies. We herein report a case of 57-year-old woman with Chiari malformation associated with significant sleep-disordered breathing. There was a family history of Chiari malformation. Although neurosurgical intervention had a significant impact on apnoea hypopnoea index (AHI) with a reduction from 81/h preoperatively to 22.1/h after the surgical treatment, it failed to cure the sleep disorder breathing completely and adaptive non-invasive servo-ventilation had a dramatic effect on symptoms and normalised the AHI. Although, central sleep apnoea is associated with a number of common disorders, this case illustrates that there may be an unusual cause. Moreover, adaptive pressure support servo-ventilation may provide a promising treatment option following surgical correction of Chiari malformation.
authors.affiliation: Department of Respiratory Medicine, Pinderfields Hospital, Mid Yorkshire Hospitals, Wakefield, UK. ahmedfahim@doctors.org.uk
authors.forename: Ahmed
authors.initials: A
authors.lastname: Fahim
authors.forename: Anthony O C
authors.initials: AO
authors.lastname: Johnson
mesh_terms: D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000601:surgery; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019635:Neurosurgical Procedures; D063087:Noninvasive Ventilation / Q000379:methods*; D020182:Sleep Apnea, Central / Q000209:etiology* / Q000601:surgery / Q000628:therapy