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The clinical features of Tumarkin falls are consistent with mechanical stimulation to the otoliths, causing a burst of neural impulses from the otolithic organs to the vestibulospinal pathways, triggering the fall. 3, 4 Because surgical ablation of the vestibular periphery cures Tumarkin falls, these falls must originate from the vestibular periphery. 3, 4 In some cases, patients report a sudden tilt of the environment simultaneous with the fall. The patients typically report the sensation of being pushed, and they fall in the same direction with repeated falls. Tumarkin 1 described patients with Meniere disease who have sudden falls that occur without warning, without loss of consciousness, and without any concomitant neurologic symptoms or sequelae. 1 - 4 Meniere disease is an inner ear disorder characterized by fluctuating hearing loss, tinnitus, and episodic vertigo. SUDDEN DROP-ATTACK falls without loss of consciousness have been noted in a small percentage of patients with Meniere disease (endolymphatic hydrops). Further studies are needed to understand the etiology of Tumarkin falls in these patients with normal hearing. The clinical description of the falls is similar to those associated with Meniere syndrome. All patients had a subjective sensation of feeling pushed by an external force, and half of the patients had a subjective tilt of the environment concurrent with the fall.Ĭonclusions The incidence of migraine is high in this subgroup of patients with Tumarkin falls and normal hearing.
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Five of 6 had a personal and/or family history of migraine headaches meeting International Headache Society criteria. Results Five of 6 patients had unilateral caloric paresis, and 1 had bilateral vestibulopathy. Quantitative audiologic and vestibular function testing, neurologic history, and examination were performed.
VERTIGO ATTACK SERIES
Methods Case series (unselected) of all patients with Tumarkin falls and a normal audiogram at least 1 year after onset of vestibular symptoms (n = 6) from a retrospective analysis of the records of all patients with Tumarkin falls presenting to Neurotology Clinic at UCLA Medical Center, Los Angeles, Calif, from October 1, 1975, to Febru(N = 55). Setting University referral center for disorders of balance and hearing. Objective To describe the clinical features and quantitative audiovestibular testing results in a case series of patients with Tumarkin falls, episodic vertigo, and normal hearing. Shared Decision Making and Communicationīackground Tumarkin falls are sudden drop-attack falls that occur in a subset of patients with Meniere syndrome (endolymphatic hydrops), an inner ear disorder characterized by vertigo spells and hearing loss.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.