2023 Volume 162 Pages 31-36
Chiari malformation type 1 (CM-1) is characterized by migration of the cerebellar tonsils below the foramen magnum. We report a 53-year-old woman who presented with a history of dizziness and unsteadiness while moving. Neuro-otological and neurological examinations revealed a central balance disorder with down-beating nystagmus. Magnetic resonance imaging of the brain showed descent of the cerebellar tonsils with the formation of a small cavity at the level of C1 of the cervical spinal cord and enlargement of the central canal caudally, based on which we made the diagnosis of CM-1 with early syringomyelia. Thereafter, the patient was successfully treated by a foramen magnum decompression surgery. The presence of CM should be considered in patients who complain of dizziness with down-beating nystagmus.