Gosalakkal Jayaprakash A
Child Development Center, Department of Paediatric Neurology, Leicester Royal Infirmary, Leicester, United Kingdom.
Pediatr Neurol. 2008 Sep;39(3):207-8. doi: 10.1016/j.pediatrneurol.2008.05.017.
Type 1 Chiari malformation is defined as an elongation of the cerebellar tonsils >6 mm below the foramen magnum. Central sleep apnea is a well-recognized sign, and can be an initial presentation, of this malformation. Obstructive sleep apnea is not a widely recognized sign of Chiari type 1 malformation, though there were a few case reports. We present a 13-year-old girl who presented at our respiratory clinic with excessive nighttime snoring. Magnetic resonance imaging revealed a Chiari type 1 malformation requiring decompression. We emphasize the importance of including cervicomedullary junction disorders in the differential diagnosis of apnea, and we review the literature concerning mixed apneas and obstructive sleep apneas in Chiari type 1 malformation.
1型Chiari畸形的定义为小脑扁桃体在枕大孔下方延长超过6毫米。中枢性睡眠呼吸暂停是这种畸形公认的体征，且可能是其首发表现。阻塞性睡眠呼吸暂停并非1型Chiari畸形广泛认可的体征，不过有一些病例报告。我们报告一名13岁女孩，她因夜间打鼾过多到我们的呼吸科门诊就诊。磁共振成像显示为1型Chiari畸形，需要进行减压手术。我们强调在呼吸暂停鉴别诊断中纳入颈髓交界处疾病的重要性，并回顾有关1型Chiari畸形中混合性呼吸暂停和阻塞性睡眠呼吸暂停的文献。
