Drop attack

Drop Attack is a medical phenomenon characterized by a sudden, unexpected fall without any preceding loss of consciousness. These attacks are instigated by various mechanisms ranging from orthopedic to hemodynamic and neurologic causes. While the term "drop attack" is expansive and may refer to a myriad of underlying causes, its use has waned in modern medicine, given advancements in diagnostic precision.

Syncope

Etiology

Drop attacks can arise from a diverse set of mechanisms:

• Orthopedic Causes: Including leg weakness and knee instability.
• Hemodynamic Causes: Such as transient vertebrobasilar insufficiency, a momentary disruption in the blood supply to the brain.
• Neurologic Causes: This encompasses epileptic seizures or impaired vestibular function.

Moreover, sudden head movements can trigger abrupt leg weakness in some individuals, which can endure for hours.

Terminology

The term "drop attack" historically served as an umbrella descriptor for unexplained falls. Given its ambiguous nature, there's been a shift towards more precise medical terminology in contemporary times. By stipulation:

Syncopal falls (fainting spells) are excluded from this category as they involve brief loss of consciousness. In the domain of neurology, a "drop attack" specifically refers to a subset of seizures manifesting in epilepsy. Some individuals in the advanced stages of Ménière's disease may suffer from drop attacks stemming from vestibular anomalies within the inner ear. Such instances are occasionally labeled as Tumarkin [drop] attacks or Tumarkin's otolithic crisis.

Demographics

Drop attacks are notably prevalent among the elderly. This demographic is susceptible to falls for multifarious reasons, encompassing both physiological and environmental factors.

Clinical Significance

Given the potential morbidity associated with falls, particularly in geriatric populations, prompt diagnosis and prevention remain paramount. Health care goals center around:

• Preventing avoidable falls.
• Accurately discerning the etiology of observed falls to facilitate appropriate management.

See also

• Epileptic seizure
• Ménière's disease
• Vertebrobasilar insufficiency
• Elderly care
• Neurology
• Orthopedics