RT Journal Article
SR Electronic
T1 peac (cyanotic expiratory apnoea of central origin) in Arnold Chiari II malformation
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP P101
DO 10.1183/23120541.sleepandbreathing-2017.P101
VO 3
IS suppl 1
A1 Adnan Zafar
A1 Nahin Hussain
YR 2017
UL http://openres.ersjournals.com/content/3/suppl_1/P101.abstract
AB Apnoea in infancy can have central or obstructive origin. Some of these episodes have mixed origin. The management of these depend on the cause and in some cases, this may require a long course of treatment in form of medical or surgical options. We report a rare case of central apnoea secondary to Arnold Chiari malformation type II. All investigations and input from neurologist pointed towards PEAC (prolonged expiratory apnoea with cyanosis) and correlated them with Type II Chiari Malformation.Failure to extubate prompted investigating for a cause. Micro laryngeal bronchoscopy revealed bilateral vocal cord palsy. In view of her apnoeic events and vocal cord palsy, a decision was made to perform a tracheostomy and start non invasive ventilation. Despite being ventilated, she had multiple profound and life threatening desaturation episodes. Most were self-terminating, lasting up to 10 seconds, some requiring stimulation and a few requiring bag-tracheostomy ventilation.These episodes were attributed to her underlying neurological condition i.e. Arnold Chiari Type II malformation. Polysomnography established the apnoeic episodes and the physiologist determined them to be central in origin. She was reviewed by neurologist who formally diagnosed them as PEAC (prolonged expiratory apnoea with cyanosis) and correlated them with Type II Chiari Malformation