Cryptogenic Drop Attacks: An Affliction of Women

Abstract

In all but one patient, falls occurred only when walking. They were not due to wearing high-heeled shoes. The average age at onset was 44 5 years and in younger women onset was often during pregnancy. The accepted causes of drop attacks were not found with certainty in any of these patients.The sex incidence and the circumstances of the falls suggest that the cause may lie in differences between the two sexes in the mechanism of walking rather than in any central disturbance. Drop attacks in women commonly occur as an isolated symptom for many years, and although distressig have no serious prognostic implicatio

Falls, faints, fits and funny turns

“…Indeed, virtually all patients remember hitting the floor, hence any possible loss of consciousness would have to be extremely short. The drop attacks nearly always occur during walking (so cardiac syncope should be included in the differential diagnosis), and only rarely during standing, unlike orthostatic syncope [41]. Other than that, there is no relation to changes in posture, head movements or any other specific precipitating event.…”

“…As such, this term has caused more confusion than understanding. If used at all, it is best to reserve the term drop attacks to denote a particular and benign syndrome of sudden, unexpected falls onto the knees without TLOC and without prodromal or postictal symptoms, and that occurs in women over 40 years of age [41]. Men are very rarely affected.…”

Guidelines on management (diagnosis and treatment) of syncope

“…Definitions vary from the very expansive, encompassing syncope and most other causes to the more restrictive. The clearest use of the term concerns 'cryptogenic drop attacks' [255] describing women (very rarely men) who suddenly drop on their knees without any apparent reason, after which patients can get up immediately; because of this the disorder is also known as 'maladie des genoux bleus'. There is no loss of consciousness, or this is so short that it cannot be ascertained with certainty by patient or doctor.…”

Guidelines on Management (diagnosis and treatment) of syncope ? update 2004

“…Definitions vary from the very expansive, encompassing syncope and most other causes to the more restrictive. The clearest use of the term concerns 'cryptogenic drop attacks' [261] describing middle-aged women (very rarely men) who suddenly drop on their knees without any apparent reason and warning, after which patients can get up immediately; because of this the disorder is also known as 'maladie des genoux bleus'. There is no loss of consciousness, or this is so short that it cannot be ascertained with certainty by patient or doctor.…”