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Epilepsy Behav. 2008 Apr;12(3):486-8. doi: 10.1016/j.yebeh.2007.12.008. Epub 2008 Jan 22.

"The choking game": self-induced hypoxia presenting as recurrent seizurelike events.

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Department of Neurology, Children's Hospital Boston, Boston, MA 02115, USA. <>


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.

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