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Drop attacks

Drop attacks. F. Khorvash Assistant Professor Of Neurology. Drop attacks are sudden spontaneous falls while standing or walking, followed by a very swift recovery, within seconds or minutes.

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Drop attacks

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  1. Drop attacks F. Khorvash Assistant Professor Of Neurology

  2. 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.

  3. Drop Attack Causes • 1.Cerebral vascular : • basilar artery insufficiency • migraine • bilateral anterior circulation occlusion • posterior circulation infarction • intracranial hematoma

  4. 2. epilepsy/paroxysmal : • neurally mediated syncope • Atonic seizure • Juvenile Myoclonic Epilepsy • cataplexy associated with narcolepsy • periodic paralyses • pure autonomic failure • episodic ataxia

  5. 3. degenerative disease : • parkinson disease • progressive bulbar palsy

  6. 4. structural : • spinal cord trauma with transient paraplegia • brainstem mass • chronic odontoid instability

  7. 5. metabolic : • hypoglycemia • hypocalcemia • hypomagnesemia • toxins, drugs”- cocaine, sedatives, antihistamine, tricyclic antidepressants

  8. 6. cardiac : • arrhythmia • sick sinus syndrome • hypovolemia • prolonged QT interval • aortic stenosis

  9. 7. psychiatric : • malingering, conversion disorder, panic, anxiety • 8. labyrinth hydrops: an overflow of endolymph in ear labyrinth causes distortions and breaks; see also Ménière's syndrome

  10. Drop Attack Management • 1.History • 2.physical examination • 3.Blood tests : CBC, FBS,Mg ,Ca ,….. • 4.Cardiac asesment :ECG , HolterManitoring , • Echocadiography,….

  11. 5.Neurologic asesment : • EEG , Brain Imaging , Tilt Table Test , • Transcranial and Cervical Doppler

  12. Drop Attack Treatment • Is according to cause

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