Vestibular drop attack: A potential origin from perilymphatic fistula?

A Pace; G Iannella; V Rossetti; A Colizza; G Magliulo

doi:10.1016/j.mehy.2020.109668

Vestibular drop attack: A potential origin from perilymphatic fistula?

Med Hypotheses. 2020 Mar 6:140:109668. doi: 10.1016/j.mehy.2020.109668. Online ahead of print.

Authors

A Pace¹, G Iannella², V Rossetti³, A Colizza⁴, G Magliulo⁵

Affiliations

¹ Organi di Senso Department University, Sapienza University of Rome, Viale del Policlinico, 151, 00161 Rome, Italy. Electronic address: annalisapace90@gmail.com.
² Organi di Senso Department University, Sapienza University of Rome, Viale del Policlinico, 151, 00161 Rome, Italy. Electronic address: giannicolaiannella@hotmail.it.
³ Organi di Senso Department University, Sapienza University of Rome, Viale del Policlinico, 151, 00161 Rome, Italy. Electronic address: valeria.rossetti92@gmail.com.
⁴ Organi di Senso Department University, Sapienza University of Rome, Viale del Policlinico, 151, 00161 Rome, Italy. Electronic address: andrea.colizza@uniroma1.it.
⁵ Organi di Senso Department University, Sapienza University of Rome, Viale del Policlinico, 151, 00161 Rome, Italy. Electronic address: giuseppemagliuloorl@yahoo.com.

PMID: 32182558
DOI: 10.1016/j.mehy.2020.109668

Abstract

Vestibular drop attacks are defined as a sudden fall to the ground without an obvious loss of consciousness lasting a few minutes or seconds. They are usually associated with Meniere's Disease during Tumarkin's phase. This hypothesis was produced in consideration of the case of a young girl affected by perilymphatic fistula and her Drop attacks. Is possible to consider perilymphatic fistulas a drop attack cause? Drop attack could be related with a vestibular sympathetic reflex alteration because it is involved in blood pressure control. Probably drop attack aetiopathogenesis may be due to a sudden change in the otolith function of the utriculus and/or sacculus. At the same time flow mechanisms of cerebrospinal fluid (CSF) have a recognized impact on the origin of vestibular drop attack. According to this, the common origin of the perilymph and of the CSF may be an important argument in favour of the potential role of the fistula in the development of drop attacks.