We describe two patients with Chiari type I malformation with unusual clinical presentation. The first one with clinical picture of acute respiratory insuficiency and the second one with vestibular and mild cerebellar syndrome and headache. In both cases the neurological examination demonstrated the presence of "downbeating nystagmus". We emphasize the value of neurological semiology, determining a correct complementary evaluation and effective treatment.
Chiari; respiratory insuficiency; vestibular and cerebellar syndrome; downbeating nystagmus