title: Evaluation of the central sleep apnea in asymptomatic children with Chiari 1 malformation: an open question.
abstract: BACKGROUND
  Type I is the most common Chiari malformation in children. In this condition, the lower part of the cerebellum, but not the brain stem, extends into the foramen magnum at the base of the skull leading to intermittent brain hypertension. In symptomatic children, central sleep apneas are shown in polysomnography evaluation. A central apnea index of 1/h or more is considered abnormal, but >5/h is clearly considered pathological. Therefore, central sleep apnea evaluation in pediatric age may show great age-related variability.
  
  
  METHODS
  We present three patients who were assessed by polysomnography with two different scores for central sleep apneas published in the literature: the method by Scholle (2011) and the American Academy of Sleep Medicine scoring system (2012).
  
  
  CONCLUSIONS
  We speculated that the Scholle scoring system can be more helpful in assessing children with asymptomatic Chiari 1 malformation for a closer follow-up. More studies are needed.
authors.affiliation: Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy. marco.zaffanello@univr.it.
authors.forename: Marco
authors.identifier: http://orcid.org/0000-0002-8659-5505
authors.initials: M
authors.lastname: Zaffanello
authors.affiliation: Department of Neuroscience, Biomedicine, and Movement Science, Neurosurgery Section, University of Verona, Verona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sala
authors.affiliation: Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Otorhinolaryngology Section, University of Verona, Verona, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Sacchetto
authors.affiliation: Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy.
authors.forename: Emma
authors.initials: E
authors.lastname: Gasperi
authors.affiliation: Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Piacentini
mesh_terms: D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000000981:diagnostic imaging*; D058070:Asymptomatic Diseases; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D020182:Sleep Apnea, Central / Q000150:complications* / Q000000981:diagnostic imaging*
keywords: Central apnea; Chiari 1 malformation; Children; Polysomnography