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Suggest Treatment For Arnold- Chiari Malformation Type-III And Cervical Spondylosis With Melopathy
Question: I have Arnold-Chiari Malformation Type III And Cervical Spondylosis w/ melopathy and have an sppointment with a surgeon this month. I have had a headache that is severe and not letting up at all for three days now. Could this be something serious? because it feels very serious.
Also I have experienced electrical shock like sensations that temorarily made me forget things. Like where i was and where i was going. it only lasted a few minutes but was very scary.
Also I have experienced electrical shock like sensations that temorarily made me forget things. Like where i was and where i was going. it only lasted a few minutes but was very scary.
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
First I must confess I am a little puzzled by the type 3 diagnosis, I think there must be a mistake there as type 3 XXXXXXX Chiari is the most severe form, it is usually incompatible with life, let alone reach adulthood. The form which is diagnosed in an adult age is Chiari 1, the most common ones, the others cause symptoms early on in infancy. So unless you are an exceptional case you should have type 1 Chiari.
The symptoms which you describe can all be found in Chiari 1, from headache which is the most common, to Lhermitte's sign (the electrical sensation down the spine, usually when bending head, can be due to myelopathy as well) and also fainting spells.
Given the extent of your symptoms I believe you will need surgery eventually to stop development of neurological deficits and symptoms. The early the better. However it does not constitute an absolute emergency, in the sense of being needed today, since you seem to have an appointment in the next few weeks it can wait till then. I am afraid ER doctors apart from pain medication can not do much more to alleviate symptoms.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
First I must confess I am a little puzzled by the type 3 diagnosis, I think there must be a mistake there as type 3 XXXXXXX Chiari is the most severe form, it is usually incompatible with life, let alone reach adulthood. The form which is diagnosed in an adult age is Chiari 1, the most common ones, the others cause symptoms early on in infancy. So unless you are an exceptional case you should have type 1 Chiari.
The symptoms which you describe can all be found in Chiari 1, from headache which is the most common, to Lhermitte's sign (the electrical sensation down the spine, usually when bending head, can be due to myelopathy as well) and also fainting spells.
Given the extent of your symptoms I believe you will need surgery eventually to stop development of neurological deficits and symptoms. The early the better. However it does not constitute an absolute emergency, in the sense of being needed today, since you seem to have an appointment in the next few weeks it can wait till then. I am afraid ER doctors apart from pain medication can not do much more to alleviate symptoms.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
OK so I really need a second opinion? When the Dr went over it in the office he drew me a picture and as he described the types he cirlced the difference in how far the "tonsil" prtruded into the spinal cord and he stopped at III and said that was where I was at. So i would say at best he said type II. He has a foreign accent so I suppose I could have mis heard him. but I origianlly was being tested for MS because my mother was diagnosed in 1996 and had been struggling with symptoms for 6 yrs. I seemed to have all of the same signs and I was worried I may have MS too. Do you feel I should get second opinion because I would rater not have surgery if it is another condition all together?
Brief Answer:
Read below.
Detailed Answer:
Thank you for that additional information. But did he actually say that it was a type 3? Because you might have misunderstood, he might have been describing simply how far down the tonsils descended in cm, or how many standard deviations below foramen magnum, or that they were descending up to 3rd cervical vertebrae. Since he has spoken only of the tonsils that is compatible with type 1, in type 2 there is involvement of brainstem and in type 3 it's the whole cerebellum (little brain) which has migrated in the spinal canal.
Anyway with MRI Chiari malformation is easy to distinguish from MS or other disorders so I am inclined to believe more in a misunderstanding than in an error. Anyway you have already scheduled the neurosurgeon appointment which will serve as a second opinion as well, it would be an appropriate specialist to consult whether on Chiari or advanced myelopathy.
Of course having surgery is up to you, you will take your own time to think about that, but if the neurosurgeon doesn't express any doubt on the Chiari diagnosis and believes that to be at the root of the symptoms (myelopathy can cause similar symptoms as well) then considering your symptoms are pronounced I would advise to have it, within the year, as I said to avoid further damage which could lead to permanent neurological deficits.
Read below.
Detailed Answer:
Thank you for that additional information. But did he actually say that it was a type 3? Because you might have misunderstood, he might have been describing simply how far down the tonsils descended in cm, or how many standard deviations below foramen magnum, or that they were descending up to 3rd cervical vertebrae. Since he has spoken only of the tonsils that is compatible with type 1, in type 2 there is involvement of brainstem and in type 3 it's the whole cerebellum (little brain) which has migrated in the spinal canal.
Anyway with MRI Chiari malformation is easy to distinguish from MS or other disorders so I am inclined to believe more in a misunderstanding than in an error. Anyway you have already scheduled the neurosurgeon appointment which will serve as a second opinion as well, it would be an appropriate specialist to consult whether on Chiari or advanced myelopathy.
Of course having surgery is up to you, you will take your own time to think about that, but if the neurosurgeon doesn't express any doubt on the Chiari diagnosis and believes that to be at the root of the symptoms (myelopathy can cause similar symptoms as well) then considering your symptoms are pronounced I would advise to have it, within the year, as I said to avoid further damage which could lead to permanent neurological deficits.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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