Chiari malformation and central sleep apnoea: successful therapy with adaptive pressure support servo-ventilation following surgical treatment

Sleep apnoea is a common disorder with significant morbidity. It is categorised into obstructive and central sleep apnoea. There are a variety of conditions associated with central sleep apnoea ranging from cardiac failure to structural brain anomalies. We herein report a case of 57-year-old woman w...

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Bibliographic Details
Published in:BMJ case reports 2012-10, Vol.2012, p.bcr-2012-007143
Main Authors: Fahim, Ahmed, Johnson, Anthony OC
Format: Article
Language:English
Subjects:
Arnold-Chiari Malformation - complications
Arnold-Chiari Malformation - surgery
Continuous Positive Airway Pressure - methods
Female
Humans
Middle Aged
Neurosurgical Procedures
Noninvasive Ventilation - methods
Novel Treatment (New Drug/Intervention
Established Drug/Procedure in New Situation)
Respiration
Sleep Apnea, Central - etiology
Sleep Apnea, Central - surgery
Sleep Apnea, Central - therapy
Sleep deprivation
Sleep disorders
United Kingdom
Ventilation
White
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Summary:Sleep apnoea is a common disorder with significant morbidity. It is categorised into obstructive and central sleep apnoea. There are a variety of conditions associated with central sleep apnoea ranging from cardiac failure to structural brain anomalies. We herein report a case of 57-year-old woman with Chiari malformation associated with significant sleep-disordered breathing. There was a family history of Chiari malformation. Although neurosurgical intervention had a significant impact on apnoea hypopnoea index (AHI) with a reduction from 81/h preoperatively to 22.1/h after the surgical treatment, it failed to cure the sleep disorder breathing completely and adaptive non-invasive servo-ventilation had a dramatic effect on symptoms and normalised the AHI. Although, central sleep apnoea is associated with a number of common disorders, this case illustrates that there may be an unusual cause. Moreover, adaptive pressure support servo-ventilation may provide a promising treatment option following surgical correction of Chiari malformation.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2012-007143