A patient with Arnold-Chiari malformation may develop disordered breathing during sleep. Sometimes it is the presenting finding for the patient. In a few patients it can result in sudden death.
Disordered breathing in a patient with Arnold Chiari malformation may be:
(1) central sleep apnea (if central areas controlling respiration are affected)
(2) obstructive sleep apnea (if the pharyngeal musculature is weak)
(3) mixed
Sleep studies with pulse oximetry and arterial blood gases may be necessary to determine the exact mechanism affecting a patient.
Differential diagnosis:
(1) phrenic nerve injury with paralysis of the diaphragm
(2) apnea from other cause
Identifying the precise cause can be helpful in determining the management strategy for a specific patient:
(1) Some patients benefit from decompression of the the posterior fossa.
(2) Some patients benefit from CPAP or other noninvasive ventilatory support.
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