Abstract

Author(s): Pedro Pascual, Aurora1; Sansano Algueró, Anna2; Mallol Badellino, Jordi 1; Ramírez Ruiz, Rosa Delia3; García Sánchez, Sonia María4; Peñalva Arigita, Amaya2; Martínez Castro, Elena1; Pizarro Serra, Sandra5

Introduction and objective: This article reviews an uncommon entity that may appear in Chiari malformation Type I, dysphagia, whose omission may exclude the diagnosis or attribute it to other pathology.

Patient: Young male with dyspnea and fever who reported 6 month’s evolution neck pain and progressive dysphagia. Suspecting aspiration pneumonia, a complete and directed medical history on the topographical areas that govern swallowing and a series of additional tests, to rule out other causes of dysphagia,were held. Cranial MRI confirmed the diagnosis of type I Chiari malformation. The patient was surgically intervened through suboccipital decompression. 6 months after surgery there was an improvement in neck pain and dysphagia disappeared.

Discussion: Dysphagia is an unusual symptom of type I Chiari malformation usually due to alteration by compression of the brainstem and/or to elongation of the lower cranial nerves. To achieve early diagnosis and proper treatment, the physical examination should be complete and directed over areas that govern swallowing, being MRI basic to establish causal diagnosis.

Conclusion: Diagnosis of Chiari malformation or other causes of lower cranial nerves impairment must be kept in mind in patients with dysphagia of uncertain origin.