Recurrent meningitis secondary to concealed cerebrospinal fluid otorrhoea.

Laryngospasm as a solitary manifestation of epilepsy is rare. It was reported in a girl who had a long history of repeated seizures.3 Nocturnal dyspnoeic attacks in children were described by Jackson and Jackson4 and defined as 'sudden dyspnoeic seizures' but no electroencephalographic correlates were reported. The usual causes oflaryngospasm, hypocalcaemia, hypoparathyroidism, or hypomagnesaemia are encountered infrequently and can easily be ruled out. Laryngospasm during anaesthesia is fairly common. The reflex laryngospasm which may appear during light anaesthesia is somewhat similar to our case. Both occur during sleep and are initiated by a remote stimulus which most probably reaches the larynx via the superior laryngeal nerve. The high frequency of attacks in our patient enabled easy documentation of the EEG abnormalities during normal sleep. In view of our findings, we feel that an EEG should be done in selected cases ofrecurrent nocturnal laryngospasm, especially those associated with alteration of consciousness. The prompt therapeutic response to carbamazepine both in our patient and in another3 supports the suggestion that this is an 'epileptic equivalent', and renders other therapeutic means unnecessary.