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Hereditary spastic paraparesis and sleep apnea. Reason for tight muscle in neck and base of skull?

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I have Hereditary spastic paraparesis and wondered if choking on my saliva when awake means my bulbar muscles are becoming involved. My have lots o tight muscles in my neck, especially at the base of my skull and on the right side. It choke several times a year on saliva but not when eating or drinking.. I have sleep apnea and use a cpap. My breathing is @11 breaths/minute.
Posted Sun, 24 Feb 2013 in General Health
Answered by Dr. Gopal Krishna Dash 4 hours later
Hello madam,
Thank you very much for posting this question in XXXXXXX

Let me explain you that any given medical problem can be due to so many causes and the aim of treating physician is to establish the exact cause and deal it accordingly.

Back to your problem, I understand that you have hereditary spastic paraparesis and you have chocking spells.

I will like to tell you that there are basically two types of hereditary spastic paraparesis

1. Classic variety where for a long period of time the symptoms are restricted to legs and hands and later it may involve other areas like bulbar muscles too.
2. Hereditary spastic paraparesis plus syndrome: Here patients can have complications and other system involvement from the beginning.

In this background illness, (I do not know the duration of illness), choking spells may indicate a possibility of bulbar involvement. Hence, I will advise you to be re-examined by your neurologist who will assess the neurological deficits and guide you regarding he treatment. Further, he will guide you regarding the problems and complications related to choking in this type of neurological diseases.

Sleep apnea will not result in the types of chocking that you have described. However, your sleep apnea needs to be treated adequately. Your CPAP compliance sheet needs to be varied by the sleep medicine specialist and the optimum pressure required for treatment of sleep apnea be verified.
I hope this will help you.
I will be happy to clear your doubts further.

Dr Gopal Krishna Dash MD (Medicine), DM (Neurology ), Post-doctoral fellowship (Epilepsy)
Consultant Neurologist and Epileptologist
Apollo Hospital
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