title: Type I Chiari malformation presenting central sleep apnea.
abstract: Sleep apnea is a rare but a well-known clinical feature of type I Chiari malformation. It may be obstructive or central in nature. Sleep apnea in patients with type I Chiari malformation rarely presents without accompanying neurological signs or symptoms. We here report a case of a 10-year-old girl who presented with central sleep apnea without any other neurological signs but was ultimately diagnosed with type I Chiari malformation. The patient initially showed mild improvement in symptoms after administration of an acetazolamide. Finally, posterior fossa decompression dramatically improved her respiratory status during sleep, both clinically and on polysomnography. This case suggests that type I Chiari malformation should be considered in the differential diagnoses of central apneas in children, even if there are no other neurological signs and symptoms. Furthermore, sagittal craniocervical magnetic resonance imaging may be necessary for a definitive diagnosis.
authors.affiliation: Department of Sleep Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan; Department of Otorhinolaryngology, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan. Electronic address: kitamura@med.uoeh-u.ac.jp.
authors.forename: Takuro
authors.initials: T
authors.lastname: Kitamura
authors.affiliation: Department of Sleep Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miyazaki
authors.affiliation: Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Nanbu-Sogo-Kenkyu-1-Goukan, Room# 513, 53 Shogoin-Kawara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kadotani
authors.affiliation: Department of Sleep Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanemura
authors.affiliation: Department of Sleep Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Okawa
authors.affiliation: Tanaka Sleep Clinic, Shijo-SET-biru 5F 99 Tachiuri-Nakano-cho, Shimogyo-ku, Kyoto 600-8006, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Otorhinolaryngology, Social Insurance Shiga Hospital, 16-1 Fujimidai Otsu, Shiga 520-0846, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Komada
authors.affiliation: Department of Neurosurgery, Fukui Red Cross Hospital, 2-4-1, Tsukimi, Fukui, Japan.
authors.forename: Taketo
authors.initials: T
authors.lastname: Hatano
authors.affiliation: Department of Otorhinolaryngology, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D000086:Acetazolamide / Q000627:therapeutic use; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D002648:Child; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D017286:Polysomnography; D020182:Sleep Apnea, Central / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D000086:Acetazolamide
keywords: Acetazolamide; Central sleep apnea; Children; Polysomnography; Type I Chiari malformation