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. 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.elderlycarotid sinusasystoleblood pressurecarotid sinus

 1.Cerebral vascular :  basilar artery insufficiencybasilar artery  migrainemigraine  bilateral anterior circulation occlusionbilateral anterior circulation occlusion  posterior circulation infarctioninfarction  intracranial hematoma

 2. epilepsy/paroxysmal :epilepsyparoxysmal  neurally mediated syncope  Atonic seizureAtonic seizure  Juvenile Myoclonic EpilepsyJuvenile Myoclonic Epilepsy  cataplexy associated with narcolepsycataplexynarcolepsy  periodic paralysesparalyses  pure autonomic failurepure autonomic failure  episodic ataxiaepisodic ataxia

 3. degenerative disease :  parkinson disease  progressive bulbar palsy

 4. structural :  spinal cord trauma with transient paraplegiaspinal cord traumaparaplegia  brainstem massbrainstem  chronic odontoid instabilityodontoid instability

 5. metabolic :  hypoglycemiahypoglycemia  hypocalcemiahypocalcemia  hypomagnesemiahypomagnesemia  toxins, drugs”- cocaine, sedatives, antihistamine, tricyclic antidepressantstoxinsdrugscocainesedatives antihistaminetricyclic antidepressants

 6. cardiac :cardiac  arrhythmiaarrhythmia  sick sinus syndrome sick sinus syndrome  hypovolemiahypovolemia  prolonged QT interval  aortic stenosis

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

 1.History  2.physical examination  3.Blood tests : CBC, FBS,Mg,Ca,…..  4.Cardiac asesment :ECG, Holter Manitoring,  Echocadiography,….

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

  Is according to cause