Drop attack: Difference between revisions

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{|style="width:80%; height:100px" border="1"
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Cardiac arrest]], [[bradycardia]], [[prolonged QT]], [[sick sinus syndrome]], [[Stokes-Adams attacks]], [[tachycardia]], [[ventricular tachycardia]], [[aortic stenosis]]
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Cardiac arrest]], [[bradycardia]], [[prolonged QT]], [[sick sinus syndrome]], [[Stokes-Adams attacks]], [[tachycardia]], [[ventricular tachycardia]], [[aortic stenosis]], [[Cardiac]] [[syncope]], [[Cardiac tamponade]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| [[Hypoglycemia]]
|bgcolor="Beige"| [[Hypoglycemia]], [[Hypocalcemia]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Gout]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Gout]], [[Paraplegia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| [[Idiopathic generalized epilepsy|Astatic seizure]] , [[Episodic ataxia]] , [[Juvenile myoclonic epilepsy]] , [[Migraine]] , [[Myoclonic seizure]] , Panayiotopoulos syndrome
|bgcolor="Beige"| [[Idiopathic generalized epilepsy|Astatic seizure]], [[Episodic ataxia]], [[Juvenile myoclonic epilepsy]], [[Migraine]], [[Myoclonic seizure]], Panayiotopoulos syndrome
[[Parkinsons]] , [[Pure autonomic failure]] , [[Seizure]] , [[Vertebrobasilar insufficiency|Vertebrobasilar artery insufficiency]] , [[Paraplegia]], [[Brain stem]] [[mass]]
[[Parkinsons]], [[Pure autonomic failure]], [[Seizure]], [[Vertebrobasilar insufficiency|Vertebrobasilar artery insufficiency]], [[Paraplegia]], [[Brain stem]] [[mass]], [[Breath-holding spells]], [[Conversion disorder]], [[Episodic ataxia]], [[Hypokalemic periodic paralysis]], [[Lennox-Gastaut Syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| [[Hypoglycemia]], [[hypocalcemia]], [[hypomagnesemia]]
|bgcolor="Beige"| [[Hypoglycemia]], [[Hypocalcemia]], [[Hypomagnesemia]], [[Gout]], [[Hypomagnesemia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Brain stem]] [[mass]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"|
|bgcolor="Beige"| [[Malingering]], [[Conversion disorder]], [[Panic attack]], [[Anxiety]], [[Panic disorder]]
 
[[Malingering]], [[conversion disorder]], [[panic attack]], [[anxiety]]
 
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Hypocalcemia]], [[Hypomagnesemia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"

Revision as of 04:01, 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:

  1. Vascular - transient ischemic attack, cerebrovascular accident, dissection, occlusion and hemorrhage
  2. Epilepsy/paroxysmal:
  3. Degenerative disease:
  4. Structural:
  5. Metabolic:
  6. Cardiac:
  7. Psychologic:

Common Causes

Causes by Organ System

Cardiovascular Cardiac arrest, bradycardia, prolonged QT, sick sinus syndrome, Stokes-Adams attacks, tachycardia, ventricular tachycardia, aortic stenosis, Cardiac syncope, Cardiac tamponade
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect Sedatives, antihistamine, tricyclic antidepressants
Ear Nose Throat No underlying causes
Endocrine Hypoglycemia, Hypocalcemia
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic Gout
Iatrogenic Antihistamines
Infectious Disease No underlying causes
Musculoskeletal / Ortho Gout, Paraplegia
Neurologic Astatic seizure, Episodic ataxia, Juvenile myoclonic epilepsy, Migraine, Myoclonic seizure, Panayiotopoulos syndrome

Parkinsons, Pure autonomic failure, Seizure, Vertebrobasilar artery insufficiency, Paraplegia, Brain stem mass, Breath-holding spells, Conversion disorder, Episodic ataxia, Hypokalemic periodic paralysis, Lennox-Gastaut Syndrome

Nutritional / Metabolic Hypoglycemia, Hypocalcemia, Hypomagnesemia, Gout, Hypomagnesemia
Obstetric/Gynecologic No underlying causes
Oncologic Brain stem mass
Opthalmologic No underlying causes
Overdose / Toxicity Cocaine
Psychiatric Malingering, Conversion disorder, Panic attack, Anxiety, Panic disorder
Pulmonary Sleep apnea
Renal / Electrolyte Hypocalcemia, Hypomagnesemia
Rheum / Immune / Allergy Anaphylaxis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Dental No underlying causes
Miscellaneous No underlying causes

Causes in alphabetical order

Diagnosis

  1. Glucose
  2. EKG
  3. Pregnancy test
  4. Urine toxicology test
  5. CT head
  6. Electrolytes
  7. Later consider EEG, echocardiogram, MRI and tilt test

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