Drop Attack in Meniere Disease

Drop attacks are sudden falls without warning that can occur without loss of consciousness or neurologic symptoms as a rare manifestation of Meniere disease. Patients typically describe a sensation of being pushed, thrown, or knocked to the ground or have a sudden illusion of environmental tilt causing the fall. This video shows a drop attack (also sometimes called an otolithic crisis, Tumarkin drop attack, or drop vestibular attack) in a 47-year-old man with Meniere disease manifest as longstanding recurrent vertigo, fluctuating hearing loss, and tinnitus in his left ear. Pathophysiology is thought to be associated with sudden changes of utricle or saccule function or by sudden stimulation and mechanical deformation caused by pressure differentials within the inner ear or by a rapid change in electrolyte levels in the endolymph and perilymph. Click the Related Article link for complete case details and discussion.