Most of the choking is caused by intracranial neuropathy, such as cerebral vascular disease, which may cause damage to the sensory nerves innervating water, leading to a more pronounced choking cough. There is also the case of thyroid surgery, total or subtotal thyroidectomy, during which the superior laryngeal nerve is damaged, which can also cause choking on water. If the recurrent laryngeal nerve is damaged, it may cause hoarseness. Therefore, it is important to be very careful during the operation to avoid damaging the nerve, and to pay special attention to avoid the risk of choking when choking on water, as well as to pay attention to the protection when eating other things. In addition, neuromuscular junction lesions such as myasthenia gravis, neurodegenerative diseases such as Parkinson’s disease, motor neuron disease, hereditary diseases such as hereditary ataxia, etc., are also prone to choking on water.