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The natural history of drop attacks

Department of Neurology (Drs. Meissner, Wiebers, and Swanson) and Section of Medical Research Statistics (Dr. O'Fallon), Mayo Clinic and Mayo Foundation, Rochester, MN.

We grouped 108 patients with drop attacks, according to potential mechanisms based on predominant associated medical conditions, as follows: unknown, 69 (64%); cardiac, 13 (12%); cerebrovascular insufficiency, 9 (8%); combined cardiac and cerebrovascular disease, 8 (7%); seizures, 5 (5%); vestibular, 3 (3%); and psychogenic, 1 (1%). Fifty-four percent of the patients received no treatment, but similar percentages of treated (82%) and untreated (84%) patients were symptom-free at follow-up. The stroke rate in the overall group, approximately 0.5% per year, was not significantly different from that in a normal age- and sex-matched population. The favorable long-term outcome in drop attack patients with unrevealing medical and neurologic workups suggests that treatment is unwarranted for an isolated drop attack.

Address correspondence and reprint requests to Dr. Wiebers, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Supported in part by Research Grant NS-6663 from the National Institutes of Health, Public Health Service.

Presented in part at the thirty-seventh annual meeting of the American Academy of Neurology, Dallas, TX, April, 1985.

Accepted for publication December 18, 1985.

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