Drop attacks are a well-known term for sudden falls without loss of consciousness. In recent years, this term has been used extensively to describe paroxysms caused by various factors, with or without loss of consciousness, which largely overlap with other conditions characterized by transient loss of consciousness. The article presents a modern view of the etiological spectrum of drop attacks. A clinical case is also presented, in which analysis of the causes of multiple, recurrent paroxysms established a rare etiology for drop attacks: a Chiari malformation type 1. The features of diagnosing drop attacks in Chiari malformation type 1 are discussed, and the differential diagnosis of these conditions is described.