We studied 36 drop seizures in 5 patients with myoclonic astatic epilepsy of 
early childhood (MAEE) with simultaneous split-screen video recording and 
polygraph. Sixteen were falling attacks and 20 were either less severe attacks 
exhibiting only deep head nodding or seizures equivalent to drop attacks in 
terms of ictal pattern but recorded in the supine position. All seizures except 
those that occurred in patients in the supine position showed sudden momentary 
head dropping or collapse of the whole body downward. Recovery to the preictal 
position was observed in 0.3-1 s. As a result of carefully repeated 
observations, the 36 seizures were classified as myoclonic flexor type in 9, 
myoclonic atonic type in 2, and atonic type, with and without transient 
preceding symptoms in the remaining 25. The MF seizure was characterized by 
sudden forward flexion of the head and trunk as well as both arms, which caused 
the patient to fall. In the myoclonic atonic seizure, patients showed brief 
myoclonic flexor spasms, immediately followed by atonic falling. The AT seizure 
showed abrupt atonic falling, with and without transient preceding facial 
expression change and/or twitching of extremities. The ictal EEGs of all 36 
seizures exhibited generalized bilaterally synchronous single or multiple 
spike(s) and wave discharges. Atonic drop attacks appear to be a common cause of 
ictal epileptic falling in MAEE.