This new paper is a case report about a 68 year old man who had developed tremor and ataxia. Positional headache was not prominent. It was not until his MRI was done that the underlying cause of spontaneous intracranial hypotension was evident. This case underscores that spontaneous intracranial hypotension may present with neurological symptoms but without prominent headache.

The journal Tremor and Other Hyperkinetic Movements is open access. This paper includes a video of the patient. Click on the PMCID number to access full text with the video.

Spontaneous Intracranial Hypotension Associated with Kinetic Tremor and Ataxia.
Salazar R1.
Tremor Other Hyperkinet Mov (N Y). 2016 Mar 9;6:366. doi: 10.7916/D8HQ3ZN5. eCollection 2016.
Abstract
BACKGROUND:
Spontaneous intracranial hypotension (SIH) is a clinically variable syndrome caused by low cerebrospinal fluid (CSF) pressure due to a non-traumatic CSF leak.
PHENOMENOLOGY SHOWN:
This case describes a 68-year-old gentleman who presents with chronic and slightly progressive kinetic tremor of bilateral hands associated with gait ataxia and gait start hesitation.
EDUCATIONAL VALUE:
This case underscores the importance of having a high index of suspicion for the diagnosis of SIH when encountering a patient presenting with late-onset progressive kinetic tremor and gait ataxia syndrome.
KEYWORDS:
Ataxia; Spontaneous Intracranial Hypotension; Tremor
PMID: 27351232
PMCID: PMC4790469
DOI: 10.7916/D8HQ3ZN5