Drop attack: Difference between revisions
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Causes of drop attacks include: | Causes of drop attacks include: | ||
# '''[[Vascular]]''' - [[transient ischemic attack]], [[cerebrovascular accident]], [[dissection]], [[occlusion]] | # '''[[Vascular]]''' - [[transient ischemic attack]], [[cerebrovascular accident]], [[dissection]], [[occlusion]] and [[hemorrhage]] | ||
#* [[Intracranial hemorrhage]] | #* [[Intracranial hemorrhage]] | ||
#* | #* [[Posterior circulation infarct|Posterior circulation infarction]], [[emboli]] and [[vasospasm]] | ||
#* [[Bilateral]] [[anterior]] [[stroke|circulation occlusion]] | #* [[Bilateral]] [[anterior]] [[stroke|circulation occlusion]] | ||
#* [[Migraine]] - develops over 1 hour, with associated [[paresthesia]], ''[[Hypertonia]] arterialis'' | #* [[Migraine]] - develops over 1 hour, with associated [[paresthesia]], ''[[Hypertonia]] arterialis'' | ||
| Line 18: | Line 18: | ||
# '''[[Epilepsy]]/paroxysmal''': | # '''[[Epilepsy]]/paroxysmal''': | ||
#* [[Neurally mediated syncope]] - 75% of all causes | #* [[Neurally mediated syncope]] - 75% of all causes | ||
#* [[Myoclonic seizure]] | #* [[Myoclonic seizure]] | ||
#* [[Idiopathic generalized epilepsy|Myoclonic-astatic seizure]] | |||
#* [[Absence seizure|Petit mal syndrome]] | |||
#* [[Lennox-Gastaut syndrome]] - [[atonic seizure]], [[myoclonic seizure]], [[Seizure classification|Generalized tonic-clonic seizure]] typically occurring in neurologically abnormal [[patients]] | #* [[Lennox-Gastaut syndrome]] - [[atonic seizure]], [[myoclonic seizure]], [[Seizure classification|Generalized tonic-clonic seizure]] typically occurring in neurologically abnormal [[patients]] | ||
#* [[Juvenile myoclonic epilepsy|Juvenile Myoclonic Epilepsy]] - [[fall]] with [[myoclonus]] | #* [[Juvenile myoclonic epilepsy|Juvenile Myoclonic Epilepsy]] - [[fall]] with [[myoclonus]] | ||
| Line 25: | Line 27: | ||
#* [[Periodic paralysis]] | #* [[Periodic paralysis]] | ||
#* [[Complex partial seizure]] | #* [[Complex partial seizure]] | ||
#* [[Breath-holding spells]] - associated [[pallor]]/[[cyanosis]], [[ | #* [[Breath-holding spells]] - associated [[pallor]]/[[cyanosis]], [[emotion]] related | ||
#* [[Pure autonomic failure]] ([[Riley-Day Syndrome]], long standing [[diabetes mellitus]]) | #* [[Pure autonomic failure]] ([[Riley-Day Syndrome]], long standing [[diabetes mellitus]]) | ||
#* [[Episodic ataxia]] | #* [[Episodic ataxia]] | ||
| Line 36: | Line 38: | ||
#* [[Brainstem]] [[mass]] | #* [[Brainstem]] [[mass]] | ||
# '''[[Metabolic]]''': | # '''[[Metabolic]]''': | ||
#* [[Hypoglycemia]] | #* [[Hypoglycemia]] | ||
#* [[Hypocalcemia]] | |||
#* [[Hypomagnesemia]] | |||
#* [[Toxins]], [[drugs]] - [[cocaine]], [[sedatives]], [[antihistamine]] and [[tricyclic antidepressants]] | #* [[Toxins]], [[drugs]] - [[cocaine]], [[sedatives]], [[antihistamine]] and [[tricyclic antidepressants]] | ||
# '''[[Cardiac]]''': | # '''[[Cardiac]]''': | ||
Revision as of 02:11, 9 April 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farman Khan, MD, MRCP [2]
Overview
Drop attacks are sudden spontaneous falls while standing or walking, followed by a very swift recovery, within seconds or minutes. Drop attacks are typically seen in elderly patients, and the most common cause is carotid sinus hypersensitivity, resulting in either short periods of reversible asystole, or in marked drop in blood pressure in response to carotid sinus stimulation.
Causes
Causes of drop attacks include:
- Vascular - transient ischemic attack, cerebrovascular accident, dissection, occlusion and hemorrhage
- Intracranial hemorrhage
- Posterior circulation infarction, emboli and vasospasm
- Bilateral anterior circulation occlusion
- Migraine - develops over 1 hour, with associated paresthesia, Hypertonia arterialis
- Basilar artery insufficiency - older patient with no loss of consciousness, transient loss of LE tone
- Epilepsy/paroxysmal:
- Neurally mediated syncope - 75% of all causes
- Myoclonic seizure
- Myoclonic-astatic seizure
- Petit mal syndrome
- Lennox-Gastaut syndrome - atonic seizure, myoclonic seizure, Generalized tonic-clonic seizure typically occurring in neurologically abnormal patients
- Juvenile Myoclonic Epilepsy - fall with myoclonus
- Laugh or cough triggered epilepsy
- Cataplexy associated with narcolepsy
- Periodic paralysis
- Complex partial seizure
- Breath-holding spells - associated pallor/cyanosis, emotion related
- Pure autonomic failure (Riley-Day Syndrome, long standing diabetes mellitus)
- Episodic ataxia
- Panayiotopoulos syndrome
- Degenerative disease:
- Structural:
- Chronic odontoid instability
- Spinal cord trauma with transient paraplegia
- Brainstem mass
- Metabolic:
- Cardiac:
- Psychologic:
Common Causes
- Seizure
- Transient ischemic attack
- Cerebrovascular accident
- Basilar artery insufficiency
- Hypoglycemia
- Hypotension
- Cataplexy associated with narcolepsy
- Cardiac arrhythmia
- Sick sinus syndrome
- Migraine
- Aortic stenosis
- Conversion disorder
Causes by Organ System
| Cardiovascular |
Cardiac arrest, bradycardia, prolonged QT, sick sinus syndrome, Stokes-Adams attacks, tachycardia, ventricular tachycardia, aortic stenosis |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | |
| Ear Nose Throat | No underlying causes |
| Endocrine |
Hypoglycemia |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | Astatic seizure , Episodic ataxia , Juvenile myoclonic epilepsy , Migraine , Myoclonic seizure , Panayiotopoulos syndrome
Parkinsons , Pure autonomic failure , Seizure , Verterbrobasilar artery insufficiency , Paraplegia, Brain stem mass |
| Nutritional / Metabolic |
Hypoglycemia, hypocalcemia, hypomagnesemia |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | Cocaine |
| Psychiatric |
Malingering, conversion, panic attack, anxiety |
| Pulmonary | Sleep apnea |
| Renal / Electrolyte | No underlying causes |
| Rheum / Immune / Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Dental | No underlying causes |
| Miscellaneous | No underlying causes |
Causes in alphabetical order
- Anaphylaxis
- Antihistamines
- Aortic stenosis
- Astatic seizure
- Bradycardia
- Brain stem mass
- Breath holding spells
- Cardiac arrest
- Cardiac syncope
- Cardiac tamponade
- Cocaine
- Conversion disorders
- Episodic ataxia
- Gout
- Hypocalcemia
- Hypoglycemia
- Hypokalemic periodic paralysis
- Hypomagnesemia
- Juvenile myoclonic epilepsy
- Lennox-Gastaut Syndrome - drop attacks
- Malingering
- Migraine
- Myoclonic seizure
- Panayiotopoulos syndrome
- Parkinsons disease
- Paraplegia
- Panic attack
- Panic disorder
- Prolonged QT
- Pure autonomic failure
- Sedatives
- Seizures
- Sick sinus syndrome
- Sleep apnea
- Spinal cord trauma
- Stokes-Adams attacks
- Superior canal dehiscence syndrome
- Tachycardia
- Trypanophobia
- Ventricular tachcardia
- Verterbrobasilar artery insufficiency