Drop attack

Depiction of a drop attack.

A drop attack is a sudden fall without loss of consciousness. Drop attacks stem from diverse mechanisms, including orthopedic causes (for example, leg weakness and knee instability), hemodynamic causes (for example, transient vertebrobasilar insufficiency, a type of interruption of blood flow to the brain), and neurologic causes (such as epileptic seizures or unstable vestibular function), among other reasons. Those affected typically experience abrupt leg weakness, sometimes after sudden movement of the head. The weakness may persist for hours.

The term "drop attack", also known as "cryptogenic drop attack" or "La maladie des genoux bleus";[1][2][3] is used to categorize otherwise unexplained falls from a wide variety of causes and is considered ambiguous medical terminology; drop attacks are currently reported much less often than in the past, possibly as a result of better diagnostic precision.[4][5] By definition, drop attacks exclude syncopal falls (fainting), which involve short loss of consciousness. In neurology, the term "drop attack" is used to describe certain types of seizure which occur in epilepsy.[6][7] Drop attacks that have a vestibular origin within the inner ear may be experienced by some people in the later stages of Ménière's disease (these may be referred to as Tumarkin [drop] attacks, or as Tumarkin's otolithic crisis).[8][9]

Drop attacks often occur in elderly people; with a majority of documented cases occurring in women.[10][11][12][13] Falls in older adults happen for many reasons, and the goals of health care include preventing any preventable falls and correctly diagnosing any falls that do happen.

References

  1. ^ Stevens, D. L.; Matthews, W. B. (1973-02-24). "Cryptogenic Drop Attacks: An Affliction of Women". Br Med J. 1 (5851): 439–442. doi:10.1136/bmj.1.5851.439. ISSN 0007-1447. PMC 1588502. PMID 4689829.
  2. ^ Butsch, Raphael; Schneemann, Markus (2014-06-27). "Two women with recurrent falls: La maladie des genoux bleus alias cryptogenic drop attacks". Case Reports. 2014: bcr2013200855. doi:10.1136/bcr-2013-200855. ISSN 1757-790X. PMC 4078483. PMID 24973344.
  3. ^ Revell, Emily R.; Gillespie, David; Morris, Paul G.; Stone, Jon (2021-01-01). "Drop attacks as a subtype of FND: A cognitive behavioural model using grounded theory". Epilepsy & Behavior Reports. 16: 100491. doi:10.1016/j.ebr.2021.100491. ISSN 2589-9864. PMC 8550987. PMID 34746733.
  4. ^ Rubenstein, L. Z. (1 September 2006). "Falls in older people: epidemiology, risk factors and strategies for prevention". Age and Ageing. 35 (Supplement 2): ii37 – ii41. doi:10.1093/ageing/afl084. PMID 16926202.
  5. ^ Bisdorff, A; Von Brevern, M; Lempert, T; Newman-Toker, DE (2009). "Classification of vestibular symptoms: towards an international classification of vestibular disorders". Journal of Vestibular Research: Equilibrium & Orientation. 19 (1–2): 1–13. doi:10.3233/VES-2009-0343. PMID 19893191.
  6. ^ Zamponi, N.; Passamonti, C.; Cesaroni, E.; Trignani, R.; Rychlicki, F. (2011). "Effectiveness of vagal nerve stimulation (VNS) in patients with drop-attacks and different epileptic syndromes". Seizure. 20 (6): 468–474. doi:10.1016/j.seizure.2011.02.011. PMID 21396833.
  7. ^ Abd-El-Barr, Muhammad M.; Joseph, Jacob R.; Schultz, Rebecca; Edmonds, Joseph L.; Wilfong, Angus A.; Yoshor, Daniel (2010). "Vagus nerve stimulation for drop attacks in a pediatric population". Epilepsy & Behavior. 19 (3): 394–399. doi:10.1016/j.yebeh.2010.06.044. PMID 20800554. S2CID 13346234.
  8. ^ Ruckenstein, MJ; Shea, JJ Jr (1999). Harris, JP (ed.). Meniere's Disease. Kugler Publications. p. 266. ISBN 978-90-6299-162-4.
  9. ^ Hayback, PJ (2012-03-06). "Mèniére's Disease". vestibular.org. Vestibular Disorders Association. Retrieved 22 September 2015.
  10. ^ Revell, Emily R.; Gillespie, David; Morris, Paul G.; Stone, Jon (2021-01-01). "Drop attacks as a subtype of FND: A cognitive behavioural model using grounded theory". Epilepsy & Behavior Reports. 16: 100491. doi:10.1016/j.ebr.2021.100491. ISSN 2589-9864. PMC 8550987. PMID 34746733.
  11. ^ Hoeritzauer, Ingrid; Carson, Alan; Stone, Jon (2016-12-01). ""Cryptogenic Drop Attacks" Revisited". Journal of Neurology, Neurosurgery & Psychiatry. 87 (12): e1. doi:10.1136/jnnp-2016-315106.45. ISSN 0022-3050.
  12. ^ Stevens, D. L.; Matthews, W. B. (1973-02-24). "Cryptogenic Drop Attacks: An Affliction of Women". Br Med J. 1 (5851): 439–442. doi:10.1136/bmj.1.5851.439. ISSN 0007-1447. PMC 1588502. PMID 4689829.
  13. ^ Butsch, Raphael; Schneemann, Markus (2014-06-27). "Two women with recurrent falls: La maladie des genoux bleus alias cryptogenic drop attacks". Case Reports. 2014: bcr2013200855. doi:10.1136/bcr-2013-200855. ISSN 1757-790X. PMC 4078483. PMID 24973344.


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