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Drop Attack: Definition, Causes, Treatments, and More

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Drop attacks are sudden falls that occur without an external physical trigger, such as tripping over something.

Drop attacks don’t involve any loss of consciousness during the fall. People regain equilibrium quickly if they weren’t hurt during the fall. Drop attacks typically last for around 15 seconds.

Drop attacks are sometimes referred to as:

  • atonic seizures
  • drop seizures
  • akinetic seizures

However, not every drop attack is caused by a seizure.

For example, Tumarkin’s otolithic crisis is a type of drop attack that’s associated with vertigo or problems with the inner ear.

Features of a drop attack

When a seizure causes a drop attack, electrical activity in the brain becomes altered without warning. This causes an immediate loss of muscle tone and strength. All or most of the muscles in the body may go limp, including the legs and arms.

You may notice some or all of these things happening:

  • If you have a drop attack and are holding something, you may drop it.
  • Your eyelids may droop, and your head may drop forward.
  • Your legs will give out, causing you to fall or slump.
  • You may experience jerking movements.
  • You’ll most likely remain conscious during this process and feel no aftereffects unless you were injured by the fall.

People who have drop attacks may also experience associated injuries and bruising, which can appear on the face, legs, and palms of the hands.

Causes

There are dozens of known causes of drop attacks, including various types of seizures, heart disorders, brain disorders, and inner ear disturbances. They include:

  • Brain tumor. Symptoms vary based on the location of the tumor.
  • Focal motor atonic seizure. This type of seizure starts in one part of the brain.
  • Generalized atonic onset seizure. The seizure starts on both sides of the brain and affects the entire body.
  • Epileptic partial seizure. Epilepsy causes several types of seizures. A simple partial seizure only affects one area of the brain.
  • Lennox-Gastaut syndrome. This is a rare form of epilepsy.
  • Dravet syndrome. This is also a rare form of epilepsy.
  • Hyperventilation. Just another way to say rapid breathing.
  • Photosensitive seizure. Exposure to flickering, flashing, or strobing lights brings on this type of seizure. Striped patterns can also trigger it.
  • Hypotension. This is also known as low blood pressure.
  • Cardiovascular syncope. Also known as fainting, this type of syncope is caused by decreased blood flow to the brain, usually associated with a slowed-down heartbeat and drop in blood pressure.
  • Carotid sinus hypersensitivity. It can cause dizziness and a drop in blood pressure.
  • Meniere disease. This is an inner ear disorder that affects balance.
  • Vertebrobasilar insufficiency. It occurs from reduction of blood flow to the back of the brain.

Diagnosis

Since there are so many causes of drop attacks, your doctor will take a thorough medical history and a family medical history. They’ll also do a physical examination.

Be prepared to let your doctor know about all the medications you take — including over-the-counter ones and supplements — and relevant details about the drop attack or attacks you’ve experienced.

For example, if you’re taking blood pressure medication and were exercising when you experienced the drop attack, your medication may need to be adjusted.

Your doctor may use tests to help them confirm a diagnosis, such as:

  • EEG (electroencephalogram) looks at brain wave patterns. Your doctor can use it to isolate issues related to the electrical activity within the brain.
  • ECog (electrocochleography) measures electrical responses within the cochlea of the inner ear.
  • Audiogram can identify problems within the inner ear.
  • ENG (electronystagmogram) measures involuntary movements of the eye. It can help identify problems with balance.
  • MRI may be used if your doctor suspects a brain tumor or other type of growth is causing your symptoms.
  • CT scan can analyze cross-sectional images of your brain.

Treatment

Treatment and prevention of drop attacks is tailored to the cause. In some instances, the cause of drop attacks will be hard to identify. It may take time to find the most effective treatment.

Treatments and preventive measures include:

  • taking medication to manage your blood pressure or pulse
  • wearing a helmet to avoid head injury during falls
  • taking antiseizure medication
  • using motion sickness medication when needed
  • using anti-nausea drugs when needed
  • stimulating the vagus nerve with an implanted device that transmits electrical energy to the brain to help control certain types of seizures
  • following a ketogenic diet, which has been found effective in some instances at reducing seizures, especially in children
  • using hearing aids, which may help in some instances
  • attending talk therapy if you have multiple incidents, as it may help you identify situations that trigger drop attacks and can also help you cope with feelings of anxiety associated with them

Special considerations

While it’s important to get a diagnosis for your specific cause of drop attack, here are a few things to consider:

  • Cardiovascular syncope may be the most common cause of drop attacks in older individuals, according to an older study from 1997.
  • Low blood pressure upon standing is another common cause.
  • Remaining hydrated and getting enough rest may help you avoid cardiovascular causes of drop attack. Your doctor may also recommend you increase your salt intake and avoid getting too hungry.
  • In some instances, your doctor may need to adjust or change your medications.
  • If your heartbeat is too slow, a pacemaker may help.
  • Older individuals may have trouble getting back up after a drop attack. If so, wearing an alerting device may be recommended.

When to see a doctor

Drop attacks may occur once or frequently. Either way, it’s a good idea to see your doctor to try to determine the underlying cause. Figuring out why a drop attack happened is one way to avoid having it happen again.

The bottom line

A drop attack is a sudden fall that seems to happen without cause. There are, however, many underlying conditions, such as heart problems and seizures, which might cause a drop attack to occur.

If you have a drop attack, see your doctor for help in determining what may have caused it and how best to treat it.

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