Factsheets for Docs-on-the-go: Chiari-1 Malformation ©2005 SJ Rodgers, Educational Therapist, and Danny Whitehead, M.D. Endorsed by Paolo Bolognese, M.D., Associate Director of The Chiari Institute Y ou know how to recognize multiple sclerosis (MS) – you probably have several cases in your busy practice. You also expect to add one or two new cases every year, because you know that 400,000 Americans have MS, and that another 200 are diagnosed every week. MS is rare, but not uncommon, so it doesn’t 1 surprise you. Did you know that similar numbers apply to Chiari-1 Malformation? 2 3 How many Chiarians have you identified in your practice? Most cases of Chiari are left undiagnosed, or worse, misdiagnosed as multiple sclerosis, migraine, fibromyalgia, or psychiatric disturbances, a common error that prevents physically ill Chiari patients from getting the kind of help they need and deserve.4 Let’s take a closer look. Chiari-1 Malformation is properly defined as a mesodermal anomaly, a deformity of the posterior cranial fossa boundaries, most notably the occipital bone, but also the tentorium, clivus, basion and opisthion. The deformity subtly compresses the cerebellum and often the occipital lobe, brainstem, and/or spinal cord, too. The cerebellar tonsils herniate into the foramen magnum and may occupy a small portion of the upper cervical spinal canal. They are visible on mid-sagittal and slightly parasagittal MRIs. However, in some cases, the tonsils wrap around the brainstem or curl up like tiny snails; then their appearance is more subtle, but their effect is just as debilitating. The reason for symptom and sign manifestation – and an important key to the severity of a case – is the deformity’s effect on cerebrospinal fluid (CSF) dynamics.5 6 When CSF flow is turbulent, reduced, or absent in one or more locations, adjacent brain tissue receives little nutritional support, cellular byproduct removal, or cushioning from the effects of mechanical or Valsalva maneuvers. Brain function in the affected areas is disturbed. Naturally, patients report debilitating effects that correspond to the malfunction of the affected brain parts. Symptoms and signs can number into the dozens, can appear to exist in unrelated systems, and 7 8 can wax and wane as influential factors change. How can you identify your Chiarians? chiariconnectioninternational/docs/Factsheets%20for%20Docs_Chiari-1%20Malformation.pdf
Posted on: Sat, 08 Jun 2013 20:40:38 +0000
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