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Letter
Chiari I malformation mimicking myasthenia gravis
  1. C Rodolico1,
  2. P Girlanda1,
  3. C Nicolosi1,
  4. G Vita1,
  5. M Bonsignore2,
  6. G Tortorella2
  1. 1Department of Neurosciences, Psychiatry and Anaesthesiology, Policlinico Universitario, Via C Valeria, Messina 98125, Italy
  2. 2Department of Paediatrics and Paediatric Surgery Sciences, Policlinico Universitario, Messina
  1. Correspondence to: Dr Carmelo Rodolico;
 crodolico{at}unime.it

https://doi.org/10.1136/jnnp.74.3.393

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    Chiari I malformation is accompanied by a variety of symptoms and signs suggesting brain stem, cerebellar, or cervical spinal cord lesions. The most common symptoms include headache, neck pain, sensory loss, and ataxia.1 Dysphagia occurs in 5–15% of the patients and it may be the only presenting symptom.2 Progressive dysphagia caused by Chiari I malformation, mimicking amyotrophic lateral sclerosis, has been reported in this journal in 1996 and 2002.2,3 Dysphonia may occur rarely, but it has not been described as an early symptom.2 Pain and stiffness in the posterior neck is a common feature, but severe neck extensor weakness leading to dropped head syndrome has not so far been reported in Chiari I malformation.

    Case report

    A 13 year old girl was admitted to our department of neurology four weeks after adenoidectomy under general anaesthesia, because of progressive difficulty in lifting her chin off her chest, together with dysphagia and dysphonia. There was no pain or stiffness in the posterior neck. Computed tomography of the …

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