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Indian Journal of Neurosurgery 2013; 02(03): 284-287
DOI: 10.4103/2277-9167.124238
Case Report
Thieme Medical and Scientific Publishers Private Ltd.

Unilateral phrenic nerve stimulation for neurogenic hypoventilation in Arnold Chiari malformation

Nitin Garg
Subject Editor:
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Publication History

Publication Date:
18 January 2017 (online)

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Abstract

Long- term ventilator dependence in patients with neurogenic hypoventilation is associated with significant morbidity and restricts mobility. Diaphragmatic pacing by phrenic nerve stimulation (PNS) is a viable alternative. This is a case report of patient with Arnold-Chiari malformation with extensive syrinx who had neurogenic hypoventilation during sleep even after foramen magnum decompression and resolution of the syrinx. Unilateral PNS was done using spinal cord stimulator. With intermittent stimulation for 8 h while asleep, patient could be weaned off the ventilator completely. At 2 years follow- up, patient is ambulant and has returned to his routine activities. PNS is a good treatment tool in patients with neurogenic hypoventilation. Spinal cord stimulator can be used with optimal results. This is first such reported case of using spinal cord stimulator for PNS from India.

Key words

Arnold-Chiari malformation - diaphragmatic stimulation - neurogenic hypoventilation - phrenic nerve stimulation - sleep apnoea - spinal cord stimulator
 

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