Many will be familiar with reports of frightening drop attacks without loss of consciousness experienced by some Meniere’s disease (MD) patients. This study analysed data from an electronic survey of over 600 members of a national Meniere’s society. The aim was to determine the frequency of Tumarkin attacks, associated self-reported complaints, their severity, consequences and impact of attacks on work. The authors defined a Tumarkin attack as “a short attack of vertigo or postural instability that was not associated with head movement”, yet in the electronic questionnaire completed by respondents, sudden loss of balance seems to be the main definition. The study reported that 49% (295 of 602) of respondents had experienced Tumarkin attacks mostly lasting seconds (278 of 602) with only 31 reporting attacks lasting a few minutes. Interestingly 23 reported daily attacks whereas, in the majority, the attacks were sporadic. However, 216 reported attacks of less than once a week. The consequences of attacks made interesting reading. Tripping and falls occurred in 133 and 92 people respectively. In the latter group 12 had fractures, three severe back injury and one had multiple fractures from a car crash. Forty-five reported transient loss of consciousness of whom 23 were witnessed. Respondents with attacks were reportedly more likely to apply for pension than not. The authors supported this with statistical analyses but possibly the MD itself is likely to have influenced the decision to retire on medical grounds. Several limitations were discussed by the authors. In my view, the authors’ definition of Tumarkin is too broad, hence the high prevalence rate of 49%. Momentary imbalance is very common without MD and as such their findings should be interpreted with caution. It is worth noting the serious consequences of Tumarkin attacks.

Impact of Tumarkin attacks on complaints and work ability in Meniere’s disease.
Pyykko I, Manchaiah V, Zou J, et al.
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Victor Osei-Lah

Bournemouth, UK.

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