title: "The choking game": self-induced hypoxia presenting as recurrent seizurelike events.
abstract: Risk-taking behavior resulting in accidental injury is common in adolescence. Self-induced hypoxia as a means of self-stimulation, sometimes referred to as "the choking game," has recently become more widely recognized, particularly with a series of well-publicized deaths in teenagers and with wider visibility on national news and Internet sites. We report a case of self-induced hypoxia via carotid compression and breath holding that presented as recurrent confusional episodes and seizurelike events. Video/EEG monitoring was a useful tool in elucidating the neurological effects of the "game," which may result in prolonged neurological injury or life-threatening outcome.
authors.affiliation: Department of Neurology, Children's Hospital Boston, Boston, MA 02115, USA. nicole.ullrich@childrens.harvard.edu <nicole.ullrich@childrens.harvard.edu>
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Ullrich
authors.forename: Ann M
authors.initials: AM
authors.lastname: Bergin
authors.forename: Howard P
authors.initials: HP
authors.lastname: Goodkin
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000150:complications*; D004569:Electroencephalography / Q000379:methods; D006801:Humans; D000860:Hypoxia / Q000150:complications* / Q000209:etiology*; D008297:Male; D010988:Play and Playthings / Q000293:injuries*; D012640:Seizures / Q000209:etiology*