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August 1964

Diagnosis, Pathogenesis, and Treatment of "Drop Attacks"

Author Affiliations

Fellow in Neurology, Mayo Foundation (Dr. Kubala); Section of Neurology, Mayo Clinic and Mayo Foundation.

Arch Neurol. 1964;11(2):107-113. doi:10.1001/archneur.1964.00460200003001

The common manifestations of disease of the vertebral-basilar arterial system have been well described in the past. However, occasionally patients experiencing insufficiency of this system describe a "dropping attack" which we feel is produced by the transient ischemia of the brain stem and which may occur more frequently than is suggested by the literature.

The drop attack occurs while the patient is standing or walking and comes on abruptly, without warning. The patient lit erally drops to the ground because of the sudden loss of muscle strength. Once fallen, the patient is usually able to get up immediately by himself and continue with his previous activity, with no visible residual of the attack. Characteristically, the patient remains fully conscious throughout this experience. Since vision, hearing, and speech remain intact, the patient is surethat there was no alteration of consciousness. The patient usually crumples to the floor quite limply and is

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