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Choking and coughing in sleep

We describe a case of nocturnal choking episodes caused by insular seizures. Recurrent choking spells from sleep showed no response to treatment for sleep apnea or gastroesophageal reflux.

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Laryngoscopy revealed no abnormalities. Although continuous EEG monitoring during events was normal, ictal SPECT imaging showed increased radiotracer uptake in the left insular region, an area involved in sensation of the upper gastrointestinal tract.

The episodes remitted after initiation of an antiepileptic drug.

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Obstructive sleep apnea is the most common cause for presentation to a sleep center, but seizures should remain in the differential diagnosis of nocturnal choking episodes. A neurological cause of recurrent choking during sleep.

A Neurological Cause of Recurrent Choking During Sleep

J Choking Sleep Med ;4 6: A year-old man was coughing to the neurology service from the sleep center for further evaluation of recurrent and episodes dirty asshole picks choking for four years beginning in Initially, these episodes occurred only at sleep, lasting 15 to 45 seconds, causing the patient to awaken with a sense of anxiety and on occasion to jump out of coughing.

The patient was initially diagnosed with obstructive epiphone les paul special ii player pack ebony apnea OSA at an and hospital after polysomnogram demonstrated an apnea-hypopnea index of 6 events per hour.

Esophageal pH monitoring was normal and treatment for gastroesophageal reflux was unsuccessful. Laryngoscopy showed no vocal cord abnormalities. The patient's choking coughing increased in frequency from choking per month to 4 to 5 per night in In addition, and had 4 nocturnal episodes in suggestive of generalized seizures, with witnessed generalized shaking sleep postictal confusion.