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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

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Sleep-disordered breathing in Chiari malformation type 1.

Jayaprakash A Gosalakkal¹

¹Child Development Center, Department of Paediatric Neurology, Leicester Royal Infirmary, Leicester, United Kingdom. jay3world@aol.com

Pediatric Neurology

|August 30, 2008

Summary

Chiari malformation type 1 can cause obstructive sleep apnea, a less recognized symptom. Early diagnosis and treatment are crucial for managing this condition and improving patient outcomes.

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Area of Science:

Neurology
Sleep Medicine
Pediatrics

Background:

Chiari malformation type 1 involves cerebellar tonsil elongation below the foramen magnum.
Central sleep apnea is a known symptom, but obstructive sleep apnea is less recognized.

Observation:

A 13-year-old girl presented with excessive nighttime snoring.
Magnetic resonance imaging confirmed Chiari malformation type 1.

Findings:

The case highlights obstructive sleep apnea as a potential, though uncommon, sign of Chiari malformation type 1.
Literature review supports the association between Chiari malformation type 1 and various apnea types, including obstructive and mixed.

Implications:

Cervicomedullary junction disorders should be considered in the differential diagnosis of sleep apnea.
Prompt diagnosis and surgical decompression may be necessary for Chiari malformation type 1 presenting with sleep disturbances.