Sleep apnea syndrome associated with a type I Chiari malformation

We report a 1-year-old girl with a type I Chiari malformation who presented with sleep apnea syndrome. Our patient experienced a change in characteristics of sleep apnea from obstructive to central after adenoidectomy was performed under general anesthesia. The patient also developed dysphagia, which worsened after adenoidectomy. Both disorders greatly diminished after posterior fossa decompression. Our results suggest that type I Chiari malformation should be considered in children with sleep apnea syndrome even when obstructive characteristics predominate. When the malformation is present, timely surgery can prevent irreversible neurologic damage. (C) 2002 Elsevier Science B.V. All rights reserved.