Risk factors affecting drop attack in patients with Meniere's disease

Drop attack (DA) is a specific symptom of Meniere's diset the risk factors affecting DAs remain uncertain. This study aimed to identify clinical and imaging predictors of DAs in MD patients .

A hospital-based cross-sectional survey was conducted between October 2014 and December 2022 at a tertiary center in shanghai, China. Patients with MD were enrolled, and data on pure tone audiometry test (PTA), Gadolinium-contrasted MRI findings, DAs and MD-Specific Symptoms were collected. Logistic regression, Kaplan-Meier survival analysis and Cox regression were used to explore risk factors.

Of 857 ease (MD), causing significant harm to patients, yrecruited patients, 823 (432 males, 391 females; mean age: 52.8 ± 13.0 years) were included in the analysis. DAs were reported in 15.2% of the cases. Among these patients, the PTA on the affected side was 54.23 ± 30.09 dB, and endolymphatic hydrops (EHs) was observed in 96% of the cohort. Logistic regression identified affected side PTA (OR = 1.01, 95% CI: 1.001-1.020), mild vertigo (OR = 4.21, 95% CI: 1.06-16.77), and severe difficulty concentrating (OR = 3.25, 95% CI: 1.4-7.53) as significant risk factors. Vestibular EHs alone did not contribute to DA risk (OR = 0.35, 95% CI: 0.15-0.82). The median time to DA onset was 57 months. The Kaplan-Meier analysis demonstrated significant differences in the incidence of DAs among patients with varying severities of vertigo. (P = 0.001). Cox regression revealed mild vertigo increased DA risk 3.4-fold (95% CI: 1.65-7.05, P < 0.01) compared to very mild vertigo.

DAs are common among MD patients, with affected-side PTA, EHs, mild vertigo, and severe difficulty concentrating identified as risk factors. The timing of DAs varies with the severity of vertigo attacks, underscoring the necessity for tailored management strategies.