Nocturnal Choking, as an Isolated Manifestation of Epilepsy

Nocturnal paroxysmal events can be easily misdiagnosed. Nighttime gasping is most often associated with obstructive sleep apnea (OSA); however, sudden awakenings with a choking sensation are also features of nocturnal epilepsy. Moreover, there may be an absence of epileptiform activity on a scalp electroencephalography (EEG) interictally and ictally, which creates a diagnostic dilemma.