Diagnosis, Pathogenesis, and Treatment of "Drop Attacks"

Kubala, Mark J.; Millikan, Clark H.

doi:10.1001/archneur.1964.00460200003001

Cited by 30 publications

(7 citation statements)

References 6 publications

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“…Vertebrobasilar ischemia was diagnosed based on history, exclusion of other causes of drop attacks, and concomitant vascular risk factors, but angiographic assessment (magnetic resonance imaging or invasive) may have proved fruitful. Previous series have shown a higher incidence of vertebrobasilar ischemia in such individuals, 24 although the diagnosis was made in the absence of a detailed cardiovascular assessment.…”

Section: Discussionmentioning

confidence: 99%

Drop Attacks in Older Adults: Systematic Assessment Has a High Diagnostic Yield

Parry

Kenny

2004

J American Geriatrics Society

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Section: Discussionmentioning

confidence: 99%

Drop Attacks in Older Adults: Systematic Assessment Has a High Diagnostic Yield

Parry

Kenny

2004

J American Geriatrics Society

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“…If additional vascular risk factors are present, the diagnosis of intermittent vertebral basilar artery insufficiency becomes more likely. 55,56 Drop attacks 57 and provokation of symptoms by head movements are not typical for BAM.…”

Section: Discussionmentioning

confidence: 99%

Basilar Artery Migraine: a Follow‐up Study of 82 Cases

1985

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SYNOPSIS 82 adolescent or adult patients in whom the diagnosis of basilar artery migraine (BAM) had been made or suspected were reviewed. When rigorous criteria were used, the diagnosis could be confirmed in 49 patients (32 women and 17 men). Seven other patients probably had BAM, but did not totally fulfill the criteria. In 26 cases reevaluation did not confirm the diagnosis. In the 49 patients with definite BAM the age of onset ranged from 10 to 62 years, 65% of them having their first attack in the second or third decade. 40% had BAM attacks only, while 60% had additionally other types of migraine attacks. A typical pattern of attacks with an “ischemic” aura followed by predominantly occipital headache was found in only 57%. The most frequent “ischemic” symptom was bilateral visual impairment (86%). Symptoms and signs of brain stem dysfunction were vertigo (63%), gait ataxia (63%), bilateral paresthesia (61%), bilateral weakness (57%), and dysarthria (57%). 77% of the cases had disorders of consciousness (mainly syncope, confusion and prolonged amnesia). 4 patients (8%) had epileptic seizures during the migraine attacks. 73% had a family history of migraine and 12% of epilepsy. EEG's were always abnormal during the attacks with predominantly localized or generalized mostly paroxysmal slow wave activity. CT scans were normal except for 2 women with repeated BAM attacks, who were smokers and taking contraceptive drugs, and who during an attack experienced a cerebellar and an occipital lobe infarction respectively. Of the 26 patients in whom the diagnosis of BAM could not be confirmed 13 had other types of migraine, while the remaining cases had temporal lobe epilepsy, intermittent vertebral basilar artery insufficiency, orthostatic hypotension or hysterical attacks.

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“…The diagnosis of vertebrobasilar insufficiency was based on a history of transient ischemic attacks with signs and symptoms referable to the territory of the vertebrobasilar arterial system (14). The most common of these were episodes of vertigo and staggering, “drop attacks” (15), photopsia, paresthesias of the hands and perioral region, incoordination, tremor and alternating hemiparesis. In addition to the history of transient ischemic attacks, there were neurologic signs referable to the vertebrobasilar territory such as nystagmus, terminal tremor and ataxia.…”

Section: Methodsmentioning

confidence: 99%

Vertebrobasilar Arterial Insufficiency with Dementia. Controlled Trials of Treatment with Betahistine Hydrochloride*

Rivera¹,

Meyer²,

Baer³

et al. 1974

J American Geriatrics Society

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A double‐blind cross‐over study was made of the effects of betahistine hydrochloride in 50 patients who had symptoms and signs of vertebrobasilar insufficiency associated with dementia, confirmed by detailed neurologic and clinical investigation. They were treated for six weeks by oral administration of either betahistine‐HCl (32 mg daily in four doses) or an identical‐appearing placebo, and then for six weeks by these preparations in reverse order. Evaluations made initially and at six‐week intervals included detailed assessment of neurologic functions rated according to a quantitative scale. A series of neuropsychologic tests was also given before and after each treatment period. Statistical analyses of neurologic and of psychologic status showed significant improvement with betahistine‐HCl therapy, particularly with respect to verbal and nonverbal cognition, memory, language use, spatial construction, perceptual‐motor coordination and perception. Measurements of regional and mean cerebral blood flow indicated a significant increase with betahistine therapy.

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Diagnosis, Pathogenesis, and Treatment of "Drop Attacks"

Cited by 30 publications

References 6 publications

Drop Attacks in Older Adults: Systematic Assessment Has a High Diagnostic Yield

Drop Attacks in Older Adults: Systematic Assessment Has a High Diagnostic Yield

Basilar Artery Migraine: a Follow‐up Study of 82 Cases

Vertebrobasilar Arterial Insufficiency with Dementia. Controlled Trials of Treatment with Betahistine Hydrochloride*

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