Chiari malformation and sleep-disordered breathing: A review of diagnosticand management issues

Chiari Malformation (CM) encompasses several patterns of congenital or acqu ired cerebellar herniation through the foramen magnum. This may result in b rain-stem compression that impacts control of breathing and is associated w ith obstructive and central apneas. A high clinical suspicion for sleep-dis ordered breathing is needed in the care of such patients after as well as b efore corrective surgery. To introduce a review of CM with a focus on the r elevance to sleep medicine, we present a case of a 13-year-old female who w as diagnosed with CM Type 1 in the course of an evaluation of symptomatic c entral sleep apnea. After initial improvement following surgery there was r ecurrence of brain-stem compression. The only clinical expression of which was polysomnographically evident recurrence of sleep apnea.