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Chapter 4 - Sudden falls

Published online by Cambridge University Press:  06 December 2010

Bettina Schmitz
Affiliation:
Vivantes Humboldt-Klinikum, Berlin, Germany
Barbara Tettenborn
Affiliation:
Johannes Gutenberg Universität Mainz, Germany
Donald L. Schomer
Affiliation:
Harvard University, Massachusetts
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Summary

The control of posture, stance and motion is highly demanding of the peripheral and central nervous system of a creature, especially if this creature is a relatively fast-moving bipedal one with a high center of gravity. With a sustained cerebral hypoxia/anoxia, a tonic phase with or without myoclonia, that is convulsive syncope, appears. Drop attacks of the vertebro-basal circulation are caused by a transient ischemia of the cortical spinal pathways or the paramedian reticular formation. Cataplexia is defined by a paresis of the skeletal muscles due to a sudden emotion. The triggering emotions are usually of a positive nature. Cataplectic attacks are most commonly triggered by sudden laughter. In startle diseases, the physiological startle reaction is pathologically increased and leads, among others things, to a paroxysmal loss of control of the body posture. In typical absence seizures, the semiology and EEG findings strongly indicate the diagnosis of idiopathic epilepsy.
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Publisher: Cambridge University Press
Print publication year: 2010

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