Department of Pediatrics, Máxima Medical Centre, Veldhoven Postbus 7777, 5500 MB Veldhoven, the Netherlands.
Eur J Pediatr. 2011 Oct;170(10):1349-52. doi: 10.1007/s00431-011-1500-z. Epub 2011 Jun 4.
A 4-year-old girl presented with sleep-disordered breathing. Her parents described breathing pauses of up to 20 s and progressive tiredness during the day. Obstructive apneas from an enlarged adenoid were thought to be the most probable cause. However, an adenotomy did not resolve the problem. Polysomnography demonstrated central apneas, and cerebral magnetic resonance imaging revealed a Chiari type I malformation. We describe the differential diagnosis of apnea in children and the role of polysomnography in the distinction between obstructive and central apneas.
This case illustrates that, in children with apnea, it is important to consider central causes as well as the more common obstructive causes, even in the absence of additional neurological signs or symptoms.
一名 4 岁女孩出现睡眠呼吸障碍。她的父母描述说，她的呼吸暂停时间长达 20 秒，白天越来越疲倦。被认为最有可能的原因是腺样体增大引起的阻塞性呼吸暂停。然而，腺样体切除术并没有解决问题。多导睡眠图显示中枢性呼吸暂停，脑磁共振成像显示 Chiari Ⅰ型畸形。我们描述了儿童呼吸暂停的鉴别诊断以及多导睡眠图在区分阻塞性和中枢性呼吸暂停中的作用。
本病例说明，对于有呼吸暂停的儿童，即使没有其他神经体征或症状，也很重要考虑中枢性原因以及更常见的阻塞性原因。
