Chiari I Malformation

Correctable by Surgery

Several years ago, on March 10, 2000, ABC News' 20/20 devoted a segment to what looked like a new treatment for those who suffer from chronic fatigue syndrome (CFS), and fibromyalgia (FM). The premise of this segment was that patients who are thought to have CFS or FM, may not have these diseases at all. Instead, they may have a condition affecting the cervical spine and/or the base of the skull. The condition in question is correctable by surgery.

The segment told the story of two patients who were thought to be disabled with CFS. One of these two was a family practitioner. The new diagnosis was a surprise, but their response to the neurosurgical decompression of the cervical spine was nothing short of thrilling.

Two neurosurgeons, Drs. Michael Rosner and Dan Heffez told how they found that many of their patients with CFS and FM were seen by them to have either cervical spinal stenosis or Chiari I malformation. It was their belief that these conditions which compress the brain stem or cervical spinal cord may be the reason for the myriad symptoms seen in CFS and FM. Rosner and Heffez contend that decompression may give sufferers relief from their symptoms.

Simplistic Claims

Yet a third neurosurgeon interviewed for the 20/20 segment expressed his concerns about CFS and FM patients rushing into surgery without there having been proper scientific study on its efficacy for these conditions, and in fact, therein lies the rub of the broadcast: there is a suggestion of an overlap of the clinical symptoms seen in CFS and FM and those of the cervical or hindbrain disorders. In the case of CFS and FM, fatigue is a dominant symptom. However, in hindbrain and cervical disorders, fatigue is only a minor symptom. To state that surgery will alleviate the symptom of fatigue, for instance, is therefore simplistic.

The Chiari malformation is also known as the Arnold Chiari malformation and can be congenital or acquired. Symptoms of the condition include headache, shooting pains or a burning sensation in the head and neck, a sensation of painful electric shock running down the spine, dizziness, loss of coordination, hearing loss, blurred vision and eye pain, weakness, difficulty picking up objects, and difficulty in swallowing.

One research study of 364 participants with Chiari I reported that 57.7% suffered from chronic fatigue, 59% had sensory abnormalities, 39% had impaired short-term memory, and 23.9% had low back pain.

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