Abstract
Introduction
Type I is the most common Chiari malformation in children. In this condition, the lower part of the cerebellum, but not the brain stem, extends into the foramen magnum at the base of the skull leading to intermittent brain hypertension. In symptomatic children, central sleep apneas are shown in polysomnography evaluation. A central apnea index of 1/h or more is considered abnormal, but >5/h is clearly considered pathological. Therefore, central sleep apnea evaluation in pediatric age may show great age-related variability.
Method and subjects
We present three patients who were assessed by polysomnography with two different scores for central sleep apneas published in the literature: the method by Scholle (2011) and the American Academy of Sleep Medicine scoring system (2012).
Conclusions
We speculated that the Scholle scoring system can be more helpful in assessing children with asymptomatic Chiari 1 malformation for a closer follow-up. More studies are needed.
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Abbreviations
- BMI:
-
Body mass index
- CAI:
-
Central apnea index
- CSAS:
-
Central sleep apnea syndrome
- CSAs:
-
Central sleep apneas
- OAHI:
-
Obstructive apnea-hypopnea index
- ODI:
-
Oxygen desaturation index
- OSAS:
-
Obstructive sleep apnea syndrome
- PSQ:
-
Pediatric sleep questionnaire
- SSEP:
-
Somato-sensory evoked potentials
- TST:
-
Total sleep time
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Authors and Affiliations
Contributions
Study conception and design: Marco Zaffanello, Francesco Sala, Giorgio Piacentini
Acquisition of data: Emma Gasperi, Luca Sacchetto, Francesco Sala
Analysis and interpretation of data: Marco Zaffanello, Francesco Sala, Luca Sacchetto
Drafting of the manuscript: Marco Zaffanello, Francesco Sala
Critical revision: Giorgio Piacentini, Francesco Sala
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The authors declare that they have no conflict of interest.
Ethical approval
The investigation was based on pre-existing clinical practice, so that ethical permission and informed consent was unnecessary. The study was performed in accordance with the Declaration of Helsinki and under the terms of all relevant local legislation.
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Zaffanello, M., Sala, F., Sacchetto, L. et al. Evaluation of the central sleep apnea in asymptomatic children with Chiari 1 malformation: an open question. Childs Nerv Syst 33, 829–832 (2017). https://doi.org/10.1007/s00381-017-3399-9
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DOI: https://doi.org/10.1007/s00381-017-3399-9