Positional dysphagia secondary to a Chiari I malformation

We describe a previously unreported phenomenon: positional dysphagia secondary to a Chiari I malformation. A 38-year-old woman presented with progressive dysphagia and cough. Flexible endoscopic evaluation of swallowing detected severe pharyngeal dysphagia and aspiration, as well as an intermittent...

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Bibliographic Details
Published in:Ear, nose, & throat journal nose, & throat journal, 2010-07, Vol.89 (7), p.318-319
Main Authors: White, David L, Rees, Catherine J, Butler, Susan G, Tatter, Stephen B, Markley, Lisa W, Cartwright, Michael S
Format: Article
Language:English
Subjects:
Adult
Anemia
Arnold-Chiari Malformation - complications
Arnold-Chiari Malformation - diagnosis
Asthma - diagnosis
Asthma - drug therapy
Asthma - epidemiology
Care and treatment
Case studies
Deglutition disorders
Deglutition Disorders - etiology
Diagnosis
Dysphagia
Endoscopy - methods
Female
Gastroesophageal Reflux - diagnosis
Gastroesophageal Reflux - drug therapy
Gastroesophageal Reflux - epidemiology
Health aspects
Humans
Larynx
Magnetic resonance imaging
Patient outcomes
Posture
Risk factors
Speech therapists
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Summary:We describe a previously unreported phenomenon: positional dysphagia secondary to a Chiari I malformation. A 38-year-old woman presented with progressive dysphagia and cough. Flexible endoscopic evaluation of swallowing detected severe pharyngeal dysphagia and aspiration, as well as an intermittent cough reflex with all consistencies in the upright position. Various compensatory strategies were attempted to relieve the aspiration, but only assumption of the supine position was successful. Subsequent magnetic resonance imaging detected a herniation of the cerebellar tonsils to the level of C2 and the presence of a cervical syrinx-findings consistent with a Chiari I malformation. After surgical decompression of the malformation, the patient's symptoms completely resolved.
ISSN:0145-5613
1942-7522