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Drop attacks with Menière's syndrome.
R W Baloh1, K Jacobson, T Winder
1Department of Neurology, UCLA Medical Center 90024-1769.
Annals of Neurology
|September 1, 1990
Summary
Patients with Meniere's syndrome can experience sudden drop attacks. These episodes, likely caused by inner ear pressure changes, are distinct from typical Meniere's symptoms and often resolve spontaneously.
Area of Science:
- Otolaryngology
- Neurology
- Inner Ear Physiology
Background:
- Meniere's syndrome is a disorder of the inner ear.
- It is characterized by episodic vertigo, tinnitus, hearing loss, and aural fullness.
- Drop attacks are a less common, distinct symptom that can occur in Meniere's syndrome.
Purpose of the Study:
- To describe the clinical features of drop attacks in patients with Meniere's syndrome.
- To investigate the potential mechanism and prognosis of these attacks.
Main Methods:
- Retrospective case series of 12 patients.
- Clinical interviews and review of medical records.
Main Results:
- Patients reported a sensation of being pushed or an illusion of environmental movement causing falls.
- Drop attacks were not associated with typical Meniere's symptoms.
- Attacks occurred at various stages of the disease, sometimes as the initial symptom.
- Episodes often remitted spontaneously, despite ongoing Meniere's progression.
- A proposed mechanism involves pressure gradients deforming otolithic membranes in the inner ear.
Conclusions:
- Drop attacks in Meniere's syndrome are a distinct clinical entity.
- They are likely caused by sudden pressure changes within the inner ear affecting otolithic organs.
- Recognition is important due to a relatively benign prognosis compared to other causes of drop attacks.