Sign Up for a Free Account
  • Updated 04.30.2024
  • Released 12.28.2004
  • Expires For CME 04.30.2027

Drop attacks

Introduction

Overview

Drop attacks are sudden falls without loss of consciousness that are not precipitated by a specific stimulus, occur with abrupt onset and without warning, and are followed by a rapid return to baseline. The author explains the clinical presentation, pathophysiology, diagnostic work-up, and management of drop attacks.

Key points

• Drop attacks are sudden falls without loss of consciousness that are not precipitated by a specific stimulus, occur with abrupt onset and without warning, and are followed by a rapid return to baseline.

• The term “drop attack” has subsequently been used to encompass a wide variety of sudden falls with or without existing conditions known to increase the risk of falls, with or without provocation by a specific stimulus, with or without loss of consciousness, and with or without significant baseline abnormalities.

• A range of localizations for drop attacks is possible, but lower brainstem or spinal cord structures are usually implicated.

• Drop attacks generally indicate transient impairment of bilateral central nervous system structures involved in maintenance of postural muscle tone and balance.

• Tumarkin otolithic catastrophes (or crises) are drop attacks without associated autonomic or neurologic symptoms in patients with severe vestibular disease, usually due to Ménière disease.

Historical note and terminology

Drop attacks are sudden falls without loss of consciousness that are not precipitated by a specific stimulus, occur with abrupt onset and without warning, and are followed by a rapid return to baseline.

For this article, drop attacks do not include so-called epileptic “drop attacks” or other seizure-related falls, presyncope or syncope, stimulus-sensitive loss of muscular tone, or falls in patients with marked nonparoxysmal leg weakness, ataxia, postural instability (eg, Parkinson disease, progressive supranuclear palsy), or sensory loss.

This is an article preview.
Start a Free Account
to access the full version.

  • Nearly 3,000 illustrations, including video clips of neurologic disorders.

  • Every article is reviewed by our esteemed Editorial Board for accuracy and currency.

  • Full spectrum of neurology in 1,200 comprehensive articles.

  • Listen to MedLink on the go with Audio versions of each article.

Questions or Comment?

MedLink®, LLC

3525 Del Mar Heights Rd, Ste 304
San Diego, CA 92130-2122

Toll Free (U.S. + Canada): 800-452-2400

US Number: +1-619-640-4660

Support: service@medlink.com

Editor: editor@medlink.com

ISSN: 2831-9125