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Chiari I Malformation and Sleep-Disordered Breathing

Alexandria C Marino1, Faraz Farzad2, John A Jane3

  • 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA, USA; Department of Neurological Surgery, University of Virginia Health Sciences Center, PO Box 800212, Charlottesville, VA 22908, USA.

Neurosurgery Clinics of North America
|November 24, 2022
PubMed

Insights

Sleep-disordered breathing (SDB) is common in pediatric Chiari I malformation. Surgical decompression may improve SDB in select young or symptomatic patients diagnosed via polysomnography.

Area of Science:

  • Neurology
  • Pediatric Neurosurgery
  • Sleep Medicine

Background:

  • Sleep-disordered breathing (SDB) is a significant symptom in pediatric Chiari I malformation, affecting at least 24% of patients.
  • Understanding the epidemiology, natural history, pathophysiology, and diagnosis of SDB in this population is crucial.

Purpose of the Study:

  • To review the current knowledge on SDB in pediatric Chiari I malformation.
  • To highlight diagnostic criteria and potential treatment outcomes.

Main Methods:

  • Literature review of case series and epidemiological data.
  • Analysis of diagnostic approaches including polysomnography.
  • Evaluation of outcomes following surgical decompression.

Main Results:

  • SDB is a frequent and important clinical feature in pediatric Chiari I.
  • Polysomnography is essential for diagnosis, particularly in young, symptomatic, or imaging-abnormal patients.
  • Surgical decompression shows promise in improving SDB in carefully selected individuals.

Conclusions:

  • SDB is a key consideration in pediatric Chiari I.
  • Timely diagnosis with polysomnography is recommended.
  • Surgical intervention may offer significant benefits for SDB in this patient group.

Keywords:
Chiari IPediatric neurosurgeryPosterior fossa decompressionSleep apnea

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