ACUTE RESPIRATORY-FAILURE AS THE FIRST SIGN OF ARNOLD-CHIARI MALFORMATION ASSOCIATED WITH SYRINGOMYELIA

We report a rare case of acute respiratory failure in a previously asy mptomatic patient showing clinical signs of inferior cranial nerve pal sy together with weakness and muscular atrophy of the upper limbs. Mag netic resonance imaging revealed Arnold-Chiari malformation associated with platybasia, basilar impression, syringomyelia and Klippel-Feil s yndrome. Episodes of apnoea required tracheostomy and recurred upon te ntative closure of the tracheostome, but remitted upon decompression o f the posterior fossa. This case involved both obstructive mechanisms and dysfunction of the respiratory centre, Patients with respiratory f ailure not explained by pulmonary pathology should be checked for unde rlying neurological disease.