A man with paraesthesia, headache, and vertigoBMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5165 (Published 23 November 2017) Cite this as: BMJ 2017;359:j5165
- Jacob O Day, core medical trainee1,
- Pragnesh Bhatt, consultant neurosurgeon2
- 1Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
- 2Aberdeen Royal Infirmary, Aberdeen, UK
- Correspondence to J Day
A 35 year old man presented to hospital with three months’ progressive paraesthesia of his right arm, leg, and torso. He also complained of intermittent headaches, particularly after coughing, and episodes of vertigo. Examination revealed hyperreflexia and numbness, with preserved joint position sense, in the right limbs. Magnetic resonance imaging (MRI) was performed (fig 1). What is the diagnosis?
Chiari malformation type 1. The MRI scan shows tonsillar descent characteristic of Chiari malformation type 1, and a resulting syringomyelia (fig 2).