Coexistence of Psychiatric Symptoms and Chiari Type I Malformation – A Case Report

by, Prof. Asoc. Dr. Voltisa Lama

Abstract

Introduction: Chiari type I malformation has been described infrequently in association with defined psychiatric syndromes. Method: There is a limited literature about obsessions in comorbidity with Chiari malformation. It is described a case of an adolescent with obsessive compulsive disorder and Chiari I malformation and it is reviewed the literature regarding Chiari I malformation and psychiatric disorders. The child came to the attention of child psychiatrist at the age of 7 years old when he manifested developmental delay and various kinds of behavioral symptoms. He was followed up at the age of fifteen when he developed obsessions and upon MRI was identified a Chiari malformation type I. Discussion: This paper discusses the likely under recognized co-occurrence of Chiari malformation and psychiatric symptoms. Currently available data from case reports associate Chiari I malformation with a variability of psychiatric symptoms: autism spectrum disorder, bipolar disorder, seizures, developmental delay, generalized anxiety disorder, panic attacks, Tourette’s syndrome, OCD, ADHD, cognitive disorder NOS and psychosis. It is concluded that mixed psychiatric symptoms and developmental delay might be a more common finding in comorbidity with Arnold Chiari type I malformation.