title: Suspected arterial gas embolism after glossopharyngeal insufflation in a breath-hold diver.
abstract: BACKGROUND
  Many competitive breath-hold divers employ the technique of glossopharyngeal insufflation in order to increase their lung gas volume for a dive. After a maximal inspiration, using the oral and pharyngeal muscles repeatedly, air in the mouth is compressed and forced into the lungs. Such overexpansion of the lungs is associated with a high transpulmonary pressure, which could possibly cause pulmonary barotrauma.
  
  
  METHODS
  We report a case of transient neurological signs and symptoms occurring within 1 min after glossopharyngeal insufflation in a breath-hold diver. He complained of paresthesia of the right shoulder and a neurological exam revealed decreased sense of touch on the right side of the neck as compared to the left side. Motor function was normal. The course of events in this case is suggestive of arterial gas embolism.
  
  
  CONCLUSIONS
  Although the diver recovered completely within a few minutes, the perspective of a more serious insult raises concerns in using the glossopharyngeal insufflation technique. In addition to a neurological insult, damage to other organs of the body has to be considered. Both acute and long-term negative health effects are conceivable.
authors.affiliation: Department of Clinical Sciences, Lund University, Lund, Sweden. Mats.Liner@med.lu.se
authors.forename: Mats H
authors.initials: MH
authors.lastname: Linér
authors.forename: Johan P A
authors.initials: JP
authors.lastname: Andersson
mesh_terms: D000293:Adolescent; D001049:Apnea; D001469:Barotrauma; D003665:Decompression Sickness / Q000150:complications*; D004242:Diving / Q000009:adverse effects*; D004618:Embolism, Air / Q000209:etiology*; D006801:Humans; D007327:Insufflation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D010292:Paresthesia / Q000209:etiology; D012119:Respiration