Monday, August 12, 2013

Arnold-Chiari I Syndrome: Symptoms, Complications, and New Treatments


If somebody you know constantly experiences yawning-induced headaches, difficulty swallowing, facial pains, or "restless leg syndrome", they might be suffering from Arnold-Chiari I syndrome.

The World Arnold Chiari Malformation Association published a series of statistics in the year 2008. The content included a list of the most common symptoms for Arnold Chiari I Syndrome. They are listed below:

Headaches in the occipito-cervical region that increases with effort, with coughing and with laughter, 90%

Fatigue, 90%

Loss of sight, 81%

Loss of balance, 81%

Loss of strength in general, 77%

General loss of equilibrium, 77%

Reduced mobility, 74%

Bright light intolerance, 74%

Vertigo when patient switches positions, 74%

Difficulty with driving, 74%

Strong reduction in patient's mobility, 74%

Difficulty when walking on uneven terrain, 74%

Pressure at neck level, 71%

Pain and/or pressure behind the eyes, 71%

Back pain (previous back injury, 34%) 71%

Points in the field of view, 68%

Neck spasms 68%

Insomnia, 61%

Ear noise, 61%

Frequent falling down, 61%

Sharp sound intolerance, confusion induced by sharp sounds, 58%

Nystagmus, 58%

Head buzzing sounds, 58%

Sense of extremity strength loss, 58%

Low muscular tone, 55%

Double vision, 55%

Difficulty while swallowing, 55%

Unusual salivation, 55%

Spontaneous vertigo, 55%

Tremors in extremities, 55%

Blood circulation issues, 55%

Sinusitis, 55%

Nausea, 52%

Neck pulsations, 52%

Difficulty while reading, 52%.

More commonly known as a "Chiari malformation," the Arnold-Chiari syndrome is a brain disorder caused by a malformed cerebellar tonsil that causes part of it to protrude into the base of the skull, through the occipital cavity or foramen magnum. This defect can slow the flow of Cerebro-Spinal Fluid (CSF) in a person's spinal column, aside from imposing pressure on brain tissue.

As the Arnold Chiari Syndrome I evolves in the patient, diagnosis becomes a challenging task. However the complications and risks that come with it are considerable. The experience can become very difficult specially for patients who are used to an active lifestyle, live alone or play an important role in the financial support of their families.

As of present, there are four types of Chiari malformations recognized by the medical community. While Types 2, 3, and 4 commonly occur in infants and children, the Arnold-Chiari I syndrome is most often found in adults, with most patients not realizing that they suffer from the condition. Most patients discover they are suffering from Chiari malformation after they start feeling the symptoms, or after an examination for an unrelated medical condition.

While speech and physical therapy can help stem the complications that arise from the Type 1 condition, they do not directly address the root cause, which is the blockage caused by the cerebellar tonsils. Patients who are severely debilitated by the more severe symptoms may need surgery to help alleviate the pressure that the tonsils impose.

Surgery is the only proper course that can directly address this problem, which normally takes the form of a decompressive craniectomy. In this procedure, the surgeon removes a section of the skull to reduce swelling in the brain. While the procedure has been successful in reducing complications for other brain injuries, it does come with considerable risks, such as brain abscesses, brain edema, and meningitis.

However, there are medical institutions that specialize in researching Chiari malformation, and have developed new surgical procedures that result in reduced post-surgery trauma and shorter recovery times for the patient.

One such treatment for the Arnold-Chiari I syndrome currently under review involves treating not the skull, but rather the filum terminale that anchors the spine. This procedure has been successfully executed during surgery on more than 1,000 patients, but is normally conducted only by clinics specializing in treatment of people suffering from Chiari, scoliosis, and other similar spinal disorders.

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