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What causes lack of balance when diagnosed with chiari malformations?

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Posted on Wed, 30 Aug 2017
Question: I have had ms like symptoms poor balance and poor coordination of arms and legs and sensory disturbacne arms/legs and I had 2 brothers stillborn to spina bifida and hydrocephalus to my understanding they are linked to chiari. anything I read online says if the tonsillar ectopia is greater than 6mm it is chiari could you advise what criteria i would need to meet to be diagnosed with chiari
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Answered by Dr. Olsi Taka (5 hours later)
Brief Answer:
Considered Chiari, but may be incidental, not cause symptoms.

Detailed Answer:
Hi,

I read your question carefully, reviewed the image, and I can understand your concern.

Technically speaking a descent of 7 mm is considered Chiari malformation (benign tonsillar ectopy is up to 5-6 mm).

That being said it doesn't mean that it is causing symptoms. Most Chiari patients with that degree of descent of the tonsils do not exhibit any symptom and lead a normal life. The fact that there is no finding of syringomyelia, myelopathy or hydrocephalus. The symptoms you describe are subjective should be confirmed by neurological exam.

If there is doubt a special MRI technique, phase contrast MRI with cerebrospinal fluid flow analysis helps understand whether manifestations are due to Chiari.

I remain at your disposal for other questions.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Olsi Taka (14 minutes later)
thank you that was very well explained, I have one last query regarding this I understand that a tonsillar ectopia can be incidental but I was knocked down by a car quite a bad accident I was left in a wheelchair for a few months is it possible that trauma on that level can make a non troublesome tonsillar ectopia become symptomatic
doctor
Answered by Dr. Olsi Taka (6 hours later)
Brief Answer:
Accident not responsible

Detailed Answer:
Thank you for the additional information.

The answer to your question is no, car accident shouldn't affect tonsillar ectopia, neither its degree nor its symptom manifestation which is due to compression and cerebrospinal fluid circulation alteration.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

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Practicing since :2004

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What causes lack of balance when diagnosed with chiari malformations?

Brief Answer: Considered Chiari, but may be incidental, not cause symptoms. Detailed Answer: Hi, I read your question carefully, reviewed the image, and I can understand your concern. Technically speaking a descent of 7 mm is considered Chiari malformation (benign tonsillar ectopy is up to 5-6 mm). That being said it doesn't mean that it is causing symptoms. Most Chiari patients with that degree of descent of the tonsils do not exhibit any symptom and lead a normal life. The fact that there is no finding of syringomyelia, myelopathy or hydrocephalus. The symptoms you describe are subjective should be confirmed by neurological exam. If there is doubt a special MRI technique, phase contrast MRI with cerebrospinal fluid flow analysis helps understand whether manifestations are due to Chiari. I remain at your disposal for other questions.