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Re: Matt CM1

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Hi Lory.

Our daughter also started having symptoms since infancy. She had swallowing

problems, choking/gagging, headaches (also held her head), abnormal UPWARD eye

movement (was misdiagnosed with Brown Syndrome due to this), among many other

symptoms. Her symptoms progressed over time and we only got a Chiari I diagnosis

when she was almost 5 years old.

Some of her symptoms would " flare " if she was ill, tired, upset and even

embarrassed. Decompression surgery (at age 5-1/2 years) alleviated her many

symptoms 1-1/2 years ago and she continues to do very well. You don't need any

tonsillar herniation to be symptomatic - our daugher had NO herniation of the

tonsils and was quite symptomatic. The problem lies with an underdeveloped

occipital bone creating a smaller compartment (posterior fossa) and thus

compression of CSF cisterns, thus restricting proper CSF flow. A smaller

compartment often causes the cerebellum to be compressed and therefore the first

thing to give are the tonsils and they will naturally be pushed downwards into

the spinal canal.

The usual procedure is to decompress the area, thus the decompression surgery.

This usually involves a removal of bone, a laminectomy of the first cervical

vertebrae (C1) and sometimes C2 as well and duraplasty. There are some

variations on this - for example, some cauterize the tonsils, some remove a

large amount of bone, some small.

Urgency? Well, our daughter's constant choking/gagging, dysphasia (swallowing

problems) and apnea/sleep apnea symptoms were reason enough as three

neurosurgeons told us it was dangerous and risky. She also started to

occasionally lose vision and even become color blind. These were reason enough

to go ahead with it, even though she had other symptoms. I would recommend you

see Chiari " experts " , get their opinions and judge for yourself about the

gravity of your son's case. The fact with our daughter was that she was

worsening with time - the symptoms were occurring more and new symptoms were

growing with time too. Only you can tell your child's situation over time.

She was decompressed by Dr Frim, U of Chicago - we live in Canada - Dr Milhorat

(NY) was the only other doc who diagnosed her with Chiari I. Many others said no

Chiari.

Feel free to ask me anything you wish.

Eurico

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