Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Arnold-Chiari Malformation's Drop Attacks?

Forum: Neurology Forum
Topic: Neurosurgery - General

Hi, I am 33 years-old female diagnosed three years ago, with ACM type one.
I have had several attacks where I would suddenly drop to the floor with loss
of muscle tone. I had trouble breathing and slurred speech. These attacks have
happened in the presence of medical staff that I work with. They thought I was
having a stoke. They rushed me to an emergency room for treatment. But, my
symptoms would resolve in a short while so they would just send me home.

My neurologist tells me it could be caused by my ACM tonsils. But, he is very
non-specific on any treatment. I worry I will have one of these attacks either
while driving or in the presence where no one is around to help me. I have
tried to find information on drop attacks related to ACM. But, I had little
luck finding any information describing these attacks. Could you possibly describe
ACM drop attack and if it corrilates with what I maybe expierencing? Is there
any treatment other than surgery to prevent these attacks. They really scare me.

Thanks for the help.

Sincerely, Anneliese


Dear Annelise,

Thank for your question,
your symptoms can certainly by explained by dysfunction of the medulla:
slurred speech, drop to the ground with or without loss of concsiousness,
and shortness of breath (the respiratory center is located in the medulla).
These symptoms are usually acute and may follow neck extension,
chiropractic manipulation, dental extraction (prolonged neck extension posture).

Unfortunately the treatment is only surgical (laminectomy and opening up the foramen magnum). Surgery is indicated ONLY if clinical progression is certain and causing disbility. If clinical progression is slight, or the disease is stable, it is probably best to leave it alone.
I share your concern about not knowing when these attack may occur.

I suggest you go over your concerns with your doctor and ask him about
the state law regarding driving.

=oOo =


This Forum's Doctors
Craig Brooker
Cleveland Clinic
Lama Chahine, MD
Cleveland Clinic
Esteban Cheng-Ching, MD
Cleveland Clinic
Cleveland Clinic, MD
Cleveland Clinic
Joanna Fong, MD
Cleveland Clinic
Expert Activity
PAD Awareness Month
11 hrs ago by Lee Kirksey, MD
When You Need to Know If You're Pre...
Sep 11 by Elaine Brown, MD

[Neurology Forum]    [Neurology Forum Archives]