What Is a Drop Attack?
Idiopathic drop attacks have previously been referred to as "cryptogenic drop attacks" or “La Maladie des genoux bleus." A drop attack is a sudden fall occurring without any physical trigger, including tripping or falling over something. Drop attacks last 12 to 15 seconds and do not involve loss of consciousness during the fall. According to a study, women are more associated with drop attacks than men, and the average age of onset of drop attacks is between 40 and 50 years. People with drop attacks would regain equilibrium immediately if they were not being hurt during the fall. For example, a drop attack called Tumarkin's otolithic type is associated with vertigo and problems with the inner ear.
What Are the Features of a Drop Attack?
When a seizure causes a drop attack, electrical activity in the brain becomes altered without warning, resulting in an immediate loss of strength and muscle tone. In such cases, most of the muscles in the body may go limp, including arms and legs. The other features one may experience during a drop attack may include:
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Experience jerking movement.
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Legs may give out, which will cause one to slump or fall.
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Drooping of the eyelid.
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Forward dropping of head.
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Falling off the things one might be holding.
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People will remain conscious during this process.
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There would be no after effects after a drop attack unless injured by the fall.
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People with drop attacks may also experience associated injuries like bruising on hands, palms, legs, face, etc.
People with drop attacks are more prone to fractures than the general population. The stroke rate in persons with drop attacks is 0.5 % every year.
What Are the Causes of a Drop Attack?
Drop attacks are caused by different reasons that include various types of seizures, heart diseases, inner ear disturbances, brain disorders, etc. They include:
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Brain Tumor - The symptoms of the brain tumor are based on the location and severity of the tumor.
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Generalized Atonic Onset Seizure - This seizure affects both sides of the brain and the entire body.
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Focal Motor Atonic Seizure - These seizures affect only one side of the brain.
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Epileptic Partial Seizure - A simple partial seizure affects only one side of the brain.
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Dravet Syndrome - This is a rare form of epilepsy.
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Lennox-Gastaut Syndrome - It is also a rare form of epilepsy.
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Hyperventilation - Hyperventilation is rapid breathing.
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Hypotension - Hypotension is known as low blood pressure. Low blood pressure on standing is also a common cause.
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Photosensitive Seizure - This seizure includes exposure to flashing, flickering, and strobing lights. Striped patterns also trigger photosensitive seizures.
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Cardiovascular Syncope - It is the most common cause of drop attacks in older people. It is also known as fainting and is caused by the decreased blood supply to the brain. It causes a slowdown of the heartbeat and decreases blood pressure.
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Meniere Disease - It is an inner ear disorder affecting balance.
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Carotid Sinus Hypersensitivity - It causes a drop in blood pressure and dizziness.
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Vertebrobasilar Insufficiency - It occurs because of the reduced blood flow to the back of the brain.
How Is a Drop Attack Diagnosed?
As many different reasons cause the drop attack, the healthcare provider will take a medical history, physical examination, and family history. Make sure to discuss one’s medications, including over-the-counter drugs and supplements. The healthcare provider may use different tests to diagnose the drop attacks.
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ECG (Electroencephalogram) - This test detects the brain's wave patterns. The healthcare provider can use this test to isolate issues related to the brain's electrical activity.
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ENG (Electronystagmogram) - ENG measures the involuntary movements of the eye and helps to detect the problems associated with balance.
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Audiogram - Audiogram is used to identify the problems associated with the inner ear.
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ECOG (Electrocochleography) - This test measures the electrical responses within the inner ear's cochlea.
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CT Scan (Computed Tomography) - CT scan is used to analyze the cross-sectional images of the brain.
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MRI (Magnetic Resonance Imaging) - MRI is used if the doctor suspects a brain tumor or any other growth in the brain that is causing the symptoms.
What Is the Treatment for a Drop Attack?
The treatment and prevention of the drop attack depends upon the cause. Sometimes, it is difficult to identify the cause of a drop attack. The treatment and preventive measures for a drop attack include:
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Use anti-nausea drugs if needed.
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Take antiseizure medications.
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Wear a helmet to avoid head injuries during falls.
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Take blood pressure medications.
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Use motion sickness medications when needed.
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Try stimulating the vagus nerve using an implanted device that transmits electrical energy to the brain. It will help to control other types of seizures.
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In children, a ketogenic diet has been found effective for reducing seizures.
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Make use of a hearing aid.
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One can avoid cardiovascular causes of drop attacks by getting enough rest and staying hydrated.
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In case of a slow heartbeat, a pacemaker can be used.
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Attend talk therapy in case of multiple falls as it may help to identify the situations and incidents that trigger drop attacks. Also, therapy will help cope with feelings of anxiety.
Conclusion:
Sometimes drop attacks are also referred to as atonic seizures, drop seizures, and akinetic seizures, but a seizure does not cause every drop attack. A sudden fall can happen without a cause, so it is important to get a diagnosis for the specific cause of a drop attack. It may occur once or frequently, so finding out the cause of a drop attack is one of the important ways to avoid having it again.
