title: Choking in the night due to NFLE seizures in a patient with comorbid OSA.
abstract: Awakenings from sleep with gasping and feeling of choking can be due to nocturnal frontal lobe epilepsy (NFLE) as well as sleep apnea (OSA). We describe the case of an overweight man, referred to us with suspected OSA and reporting awakenings from sleep accompanied by gasping and a choking feeling, which proved to be, after investigation, NFLE seizures in a patient with comorbid OSA. We underline that gasping or choking on awakening, especially when accompanied by abnormal motor-behavioral manifestations, should be interpreted with caution. Careful investigation by means of video-polysomnography is warranted in selected cases, including patients with a strong clinical suspicion of sleep apnea.
authors.affiliation: Sleep Medicine and Epilepsy Unit - C. Mondino National Neurological Institute, Pavia, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Terzaghi
authors.affiliation: Epilepsy Surgery Centre "C. Munari" Sleep Disorders Centre, Niguarda Hospital, Milan, Italy.
authors.forename: Ivana
authors.initials: I
authors.lastname: Sartori
authors.affiliation: Sleep Medicine and Epilepsy Unit - C. Mondino National Neurological Institute, Pavia, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cremascoli
authors.affiliation: Sleep Medicine and Epilepsy Unit - C. Mondino National Neurological Institute, Pavia, Italy.
authors.forename: Valter
authors.initials: V
authors.lastname: Rustioni
authors.affiliation: Sleep Medicine and Epilepsy Unit - C. Mondino National Neurological Institute, Pavia, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Manni
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000150:complications*; D000927:Anticonvulsants / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use; D045422:Continuous Positive Airway Pressure / Q000379:methods; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000379:methods; D017034:Epilepsy, Frontal Lobe / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications; D017286:Polysomnography / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine
keywords: epilepsy; nocturnal frontal lobe epilepsy; sleep; sleep apnea