08/20/2026
Someone commented, and I cannot find who commented it, but they said the following:
"My dad has been diagnosed with cerebellar stroke a year ago from last one month he is having chocking fit ( sometimes while eating or drinking & sometimes normally ) average 4-5 times a day , doctor has prescribed the telecast L (montelucast + levocritizine ) but have not got much relief from that. Can you guys give some suggestions as to what the problem actually is and what are its treatment and precautions?"
My reply:
I'm going to be straight with you because this one matters.
What you're describing sounds like dysphagia — swallowing dysfunction. It's one of the most common consequences of a cerebellar or brainstem stroke, and it's not rare. Swallowing is a coordinated motor sequence. The stroke damaged the signal that coordinates it. Food and liquid are going toward the airway instead of the stomach, and the choking is his body trying to protect him.
Montelukast + levocetirizine is an asthma and allergy combination. If the problem is a broken swallow signal, that medication isn't aimed at the problem — which would explain why a month of it hasn't helped.
What to ask for, and ask this week: a formal swallow evaluation by a speech and swallowing therapist. The tests are a Modified Barium Swallow Study (videofluoroscopy) or a FEES (fiberoptic endoscopic evaluation of swallowing). These actually show where the breakdown is — and whether he's aspirating silently, which is the part that scares me. Some people aspirate without coughing at all.
Why the urgency: food or liquid going into the lungs leads to aspiration pneumonia. That's one of the leading causes of death after stroke, and it's preventable. Four to five episodes a day is not a "wait and see" situation.
Precautions starting today, until he's evaluated:
Fully upright, 90 degrees, for every meal and drink. No reclining, no eating in bed.
Chin slightly tucked toward the chest when swallowing.
Small bites, small sips. One at a time. No stacking.
No talking while food is in his mouth.
No straws for thin liquids — thin liquids move too fast to control. Water is often the hardest thing to swallow, not the easiest.
Stay upright 30 minutes after eating.
Keep his mouth and teeth clean. Oral bacteria plus aspiration is what turns into pneumonia.
Go to emergency if you see: fever, a wet or gurgly voice after eating or drinking, coughing that won't settle, or weight loss.
Now the part most people won't tell you. A broken swallow signal is still a signal — and signals can be retrained. Swallowing is a motor function, same as walking or reaching. It responds to targeted work. But you need the evaluation first so the work is aimed at the right thing instead of guessed at.
Get the swallow study. Then if you want to talk about the rehab side and what rebuilding looks like for him, we do a free 30-minute Zoom consult — no cost, no obligation. [email protected] or +1 (301) 653-0941.
I'm not his doctor and this isn't a diagnosis. But I've been on the wrong end of doctors treating the wrong problem for 18 months, and I'm not going to watch it happen to your dad quietly.
