Chiari 1 Malformation and Fibromyalgia

A chiari malformation, in general, is a defect in which part of the brain pushes into the spinal cord through a hole in the skull. Chiari malformations are divided into four subtypes, depending on anatomy of the malformation and whether the malformation was present at birth (congenital) or developed during growth later in life.Chiari malformation types I and II are the more common varieties. Chiari 1 malformation is less severe than the second type of chiari malformation because the second type is present at birth, while the first type develops slowly while a person is growing. In a chiari 1 malformation, part of the brain pushes through the large hole in the bottom of the skull, called the foramen magnum, that the spinal cord goes through. Thus, the type I chiari malformation may not be noticed until the person is an adolescent or an adult, and in some cases, the malformation is never diagnosed because the person never gets an MRI of the head that can reveal this malformation. Chiari malformation types III and IV are both more severe than types I and II and present at birth. Type III involves a large brain herniation through the skull where the cerebellum or brain stem protrudes, and type IV is compounded with other severe neurological defects.

There is some talk about similarity of chiari I malformation symptoms and symptoms of chronic pain diseases, especially fibromyalgia and chronic fatigue syndrome. Chiari 1 malformations in adults, when they actually cause symptoms, can cause many symptoms that overlap with fibromyalgia symptoms. For example, fatigue, insomnia, impaired focus and memory, mood problems, leg cramps, muscle pain and migraine headaches are some of the symptoms that are common to both chiari 1 malformations and fibromyalgia.

Chiari malformations are much more rare than fibromyalgia, especially if you are comparing symptomatic chiari malformations and fibromyalgia. That is, many chiari type I malformations do not cause symptoms at all, so it is rare that a person who presents with fibromyalgia symptoms will actually end up having a previously undiagnosed chiari type 1 malformation. Chiari malformations can easily be diagnosed with an MRI scan of the head or a CT scan. If a chiari 1 malformation is detected, treatment depends on the severity of the brain herniation and the symptoms that are occurring. Some symptomatic treatment, such as prescription of pain killers or use of over-the-counter pain killer medications, may be appropriate. Anti-inflammatory medications can also help relieve symptoms. A person with a chiari 1 malformation may need regular MRI or CT scans to monitor the malformation and make sure that it is not getting worse over time. In some cases, surgery may be necessary to treat a chiari malformation. The goal of chiari malformation surgery is to reduce pressure on the herniated part of the brain.

Chiari 1 malformations are symptomatically similar in some respects to fibromyalgia, but they are distinct conditions. Chiari 1 malformations can also cause some symptoms that are not usually found in fibromyalgia, including peripheral neuropathy, sleep apnea and serious problems with balance and motor control. It would be rare, but possible, for a person to be suffering from both conditions at the same time, but this is a chance occurrence. Anatomical studies of fibromyalgia patients suggest that there is little link between fibromyalgia and degree of brain herniation through the foramen magnum. Thus, chiari malformations are not a cause of fibromyalgia.


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