This 2016 paper from the open-access journal Tremor and Other Hyperkinetic Movements is a case report about a 68-year-old man who developed tremor and ataxia and did not have a positional headache. 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 paper, linked below, includes a video of the patient.
Spontaneous Intracranial Hypotension Associated with Kinetic Tremor and Ataxia
AUTHOR: Salazar R.
CITATION: Tremor Other Hyperkinet Mov (N Y). 2016 Mar 9;6:366. doi: 10.7916/D8HQ3ZN5. eCollection 2016.
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
Further reading
For more on spontaneous intracranial hypotension, spinal CSF leak, and ataxia and other diagnostic challenges, see the following article.