Neuropediatrics 2004; 35 - V1
DOI: 10.1055/s-2004-819346

Sleep-disordered breathing in myelomeningocele

C Schropp 1, S Wenzel 1, S Müller-Stöver 1, G Handwerker 1, J Krauß 2, HM Straßburg 1
  • 1University Children's Hospital Wuerzburg
  • 2Department for Pediatric Neurosurgery, University of Wuerzburg, Germany

Objective: To study types and severities of sleep-disordered breathing (SDB) in patients with myelomeningocele (MMC).

Methods: 38 patients underwent a total of 125 polysomnographies (PSG; age range at initial PSG, 1 month –18 years; mean age, 7.1 years). Cranio-cervical MRI or computed tomography was available in 24 patients and showed Chiari II malformations in 22 cases. History, clinical and radiological findings were extracted retrospectively from patient records.

Results: Initial PSG was abnormal in 27/38 patients. Central apnoeas dominated in 21, obstructive apnoeas in 6 patients. In both groups, desaturations were unexpectedly sudden even with short apnoeas. In addition, 7 patients showed a low baseline oxygen saturation (<92%), 11 patients an abnormally elevated heart rate during sleep. Therapeutic measures included methylxanthines (n=7), CPAP (n=2), oxygen (n=3), adenotonsillectomy (n=1), combinations of conservative options (n=3), and Chiari decompression (n=4).

Conclusion: Sleep-disordered breathing is a frequent finding in patients with MMC. Most patients showed central apnoeas, obstructive apnoeas were observed less frequently. Both groups show sudden desaturations even with short apnoeas.

Keywords: myelomeningocele, Chiari II-Malformation, sleep-disordered breathing