Drop attack: Difference between revisions
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*[[Paraplegia]] | *[[Paraplegia]] | ||
*[[Panic attack]] | *[[Panic attack]] | ||
*[[Panic disorder]] | |||
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*[[Prolonged QT]] | *[[Prolonged QT]] | ||
*[[Pure autonomic failure]] | *[[Pure autonomic failure]] | ||
Revision as of 02:36, 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 and 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 |