Drop Attack: Causes, Symptoms, Treatment, Diagnosis

Sudden fall without any external trigger is known as a drop attack. These attacks are not precipitated by a specific stimulus. There is an abrupt onset without any warning with a rapid return to baseline.

The consciousness is not lost and the event is remembered. It is a serious problem.

Drop attacks are also referred to as, atonic seizures, drop seizures, or akinetic seizures.

Most of the drops attacks are never definitively established. It can be due to syncope, poor circulation to the brain, problems with the heart and brain, problems in the inner ear (Meniere’s disease), and also due to some psychological problems. Drop attacks occurring from Meniere’s are more active and the patient tends to fall.

There can be various conditions that can cause drop attacks which include various types of seizures, heart disorders, brain disorders, and inner ear infection.

• Brain tumor and the symptoms are based on the location of the symptoms
• Focal motor atonic seizure which starts in one part of the brain
• Generalized atonic onset seizure which starts on both side of the brain and affects the entire body balance.
• Epileptic partial seizure, a simple partial seizure that affects one area of the brain. It can cause several types of seizures.
• Dravet syndrome, a rare form of epilepsy.
• Hyperventilation or rapid breathing.
• Photosensitive seizure, triggered by flickering, flashing, or strobing light
• Hypotension
• Meniere disease, an inner ear disorder that affects body’s balance.
• Vertebrobasilar insufficiency occurs due to the reduction of blood flow back to the brain.
• Cardiovascular syncope, caused by decreased blood flow to the brain which leads to fainting. A study shows cardiovascular syncope to be the most common cause of drop attacks in elderly individuals ⁽¹⁾.
• Lennox-Gastaut syndrome, a rare form of epilepsy.

If suffering from a drop attack, the following symptoms will be observed:

• Dropping off anything that is in hand
• Drooping of eyelid
• Jerking movements
• Legs give out, making you fall in a slump
• The person remains unconscious during the attack
• Injury or bruising of the part fell on
• Pain at the site injured, if any, during the fall

A thorough medical history is taken which involves family history. A physical examination is also done.

It is important to inform the doctor about any medication course you are going through, for example, blood pressure medicine, diabetes medicine, any other over the counter prescription, or supplements.

To confirm the diagnosis the following tests are advised by the doctor:

• EEG or electroencephalogram: It gives a look at the brain wave patterns. It helps isolate the issues related to the electrical activity of the brain.
• Audiogram: This test helps identify the problems with the inner ear.
• ECog or electrocochleography: The test helps measure the electrical response in the cochlea of the inner ear.
• ENG or electronystagmogram: This test measures the involuntary movement of the eyes and identifies the problem related to the balance.
• MRI: This test is advised if the doctor suspects a brain tumor or any other type of growth causing the symptoms.
• CT scan: It helps visualize cross-sectional images of the brain

Treatment of drop attacks depends on the cause of the condition. The treatment and preventive measures include:

• Keeping the blood pressure level under control and taking medication regularly.
• Wearing a helmet to avoid head injury.
• Taking antiseizure medicine if prescribed regularly
• If needed, take anti-nausea drug
• Following a ketogenic diet has been seen as beneficial in preventing seizures, especially in children ^(1).
• Identifying the triggers of the problem which is causing drop attack. And knowing how to keep away from them or how to solve them.

Staying hydrated and getting enough rest, help avoid the cardiovascular cause of drop attack. In some cases doctor might make a few changes in the medicine to help get over it.

If suffering from drop attack, see a doctor to help determine the cause and cure it.