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Nocturnal choking episodes: under-recognized and misdiagnosed
Muruvet Elkay1, Annapurna Poduri, Sanjay P Prabhu
1Division of Epilepsy & Clinical Neurophysiology, Department of Neurology, Children's Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA. Muruvet.Elkay@childrens.harvard.edu
Pediatric Neurology
|October 12, 2010
Summary
Nocturnal paroxysmal events, like seizures or panic attacks, can cause choking episodes. Accurate diagnosis is vital for effective treatment, as these conditions are often misdiagnosed.
Area of Science:
- Neurology
- Sleep Medicine
- Psychiatry
Background:
- Nocturnal paroxysmal events encompass diverse conditions including epileptic seizures, parasomnias, sleep-related movement disorders, and psychiatric disturbances.
- Accurate diagnosis is essential for appropriate management, yet under-recognition and misdiagnosis of non-epileptic events are common.
Observation:
- This study presents two cases of nocturnal paroxysmal events presenting with choking episodes.
- Case one involved nocturnal panic attacks, while case two featured frontal lobe epilepsy.
Findings:
- The semiology and timing of events, combined with video-electroencephalography and patient history, aid in differential diagnosis.
- Both nocturnal panic attacks and frontal lobe epilepsy can manifest as choking episodes during sleep.
Implications:
- Highlighting the diverse presentations of nocturnal paroxysmal events is crucial for clinicians.
- Improved diagnostic strategies can reduce misdiagnosis rates and ensure timely, appropriate patient management.
- Recognizing choking episodes as a potential symptom of both epileptic and psychiatric disorders is important.
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