Short Communication | DOI: https://doi.org/10.31579/2690-1919/525
Assistant PhD, “Titu Maiorescu” University, Faculty of Medicine, Bucharest, Memormed Medical Centre Bucharest, Romania.
*Corresponding Author: Mariana-Alis Neagoe, Assistant PhD, “Titu Maiorescu” University, Faculty of Medicine, Bucharest, Memormed Medical Centre Bucharest, Romania.
Citation: Mariana-Alis Neagoe, (2025), Underdiagnosed Drop Attacks, J Clinical Research and Reports, 19(4); DOI:10.31579/2690-1919/525
Copyright: © 2025, Mariana-Alis Neagoe. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Received: 31 March 2025 | Accepted: 07 April 2025 | Published: 11 April 2025
Keywords: drop attack; transient vertebrobasilar insufficiency; imaging tests
A drop attack is a sudden fall caused by a collapse of postural muscle tone, which causes leg weakness, without loss of consciousness, being determined by brainstem ischemia.
In current medical practice, diagnostic errors frequently occur, due to incomplete investigation of the patient who is directed to other medical services.
The term has been assigned to falls that occur without warning and without loss of consciousness or postictal symptoms. The patient, usually of old age, falls unexpectedly while walking or standing, rarely when standing still. The knees bend inexplicably. There is no dizziness or loss of consciousness, and the fall usually occurs forward, with injury to the knees and sometimes the nose. The patient, except for the obese patients, is able to get up immediately and continue walking, quite embarrassed. There may be a few repeated attacks followed by a period with no attacks. The electrocardiography (ECG) and electroencephalography (EEG) performed between the events show normal results. [1]
In rare cases, the Meniere's disease, in which the patient falls ("Tumarkin's otolithic crisis") may be mistaken for a syncope or drop attack, but only for a short period of time until vertigo occurs. [1]
Orthopaedic and rheumatological physicians are familiar with falls caused by the sensation of knee bending, which they attribute to arthritic and tendinous pathology of the knee. [1]
Central disequilibrium is probably the most common cause of the so-called drop attacks, sudden falls without warning or loss of consciousness in older individuals. Drop attacks were originally attributed to disease of the vertebrobasilar system, but this etiology of drop attacks in the elderly is probably not as common as subcortical hemispheric disease. [2] BAO(basilar artery occlusion) presents with a bewildering variety of manifestations. In addition to headache, which is most common and least specific, symptoms include vertigo (ischemia of the vestibular nuclei and pathways); visual disturbances (occipital lobes); unilateral or bilateral hypesthesia or anesthesia (medial lemnisci, spinothalamic tracts, or thalamic nuclei); tinnitus and hearing loss (cochlear nuclei or lateral lemnisci); drop attacks (transient ischemia of the corticospinal tracts); ataxia (cerebellum or cerebellar pathways); Horner syndrome (oculosympathetic pathways in the brainstem); and confusion, amnesia, dreamlike behavior (thalamic nuclei and medial temporal lobes). (3)
Patient medical history and neurological examination can usually identify disorders that require an emergency intervention. Substituting thorough clinical evaluation with CT (computed tomography), MRI (magnetic resonance imaging), and laboratory tests can lead to errors and considerable costs. [4]
Dear Editorial Team, Clinical Medical Reviews and Reports. My experience with the journal was highly positive. The peer-review process was rigorous, constructive, and completed in a timely manner. The reviewers provided valuable comments that helped improve the quality and clarity of our manuscript. The editorial office was professional, responsive, and supportive throughout all stages of the publication process. Communication was clear and efficient, and any questions were addressed promptly. Overall, I found the journal to maintain high scientific standards and an excellent publication workflow. I would be pleased to consider submitting future work to this journal. Best wishes from, Elena Popa.
It was my pleasure to submit my testimonial concerning the Reviewer Board of our Scientific Journal “Brain and Neurological Disorders”. The Reviewers focused on some modifications and their contribution was helpful. The ladies of our Editorial Office were also supported my efforts. It was my honor to have such a co-operation and I am looking forward for more collaboration.
Dear Grace Pierce, Editorial Coordinator of Journal of Clinical Research and Reports, Thank you for the speedy and efficient peer review process. I appreciate the fact that your peer reviewers do not take months to respond like with some other journals. I would also like to thank the editorial office for responding quickly to my questions. It is an excellent journal. I plan to submit more manuscripts in the future. Best wishes from, Robert W. McGee
Dear Grace Pierce, Editorial Coordinator of Journal of Clinical Research and Reports, Working with you and your team on our recent publication in JCRR has been a truly wonderful and enjoyable experience. The responses were prompt, and the reviewers were patient, constructive, and highly professional. One reviewer in particular gave me the feeling that a professor was carefully reading and commenting on my coursework, which was deeply touching. The entire process was straightforward and hassle‑free, with no tedious online forms to complete. I highly recommend this journal. Best wishes from, DR Aibing Rao, Head of R&D
I Appreciate the Opportunity to Share my Experience with the Journal of Clinical Research and Reports. The peer review process was timely and constructive, and the feedback provided helped improve the quality of our manuscript. The editorial office was professional, responsive, and supportive throughout the process, ensuring smooth communication and efficient handling of the submission. Overall, it was a positive experience collaborating with your team.
Dear Mercy Grace, Editorial Coordinator of Obstetrics Gynecology and Reproductive Sciences, We would like to express our gratitude for your help at all stages of publishing and editing the article. The editors of the magazine answer all the necessary questions and help at every stage. We will definitely continue to cooperate and publish other works in the Obstetrics Gynecology and Reproductive Sciences! Best wishes from, Alla Konstantinovna Politova,
