# Inadvertent Dural Puncture Causing Low Pressure Headache and Peripheral Vestibular Bilateral Damage

## TL;DR

A rare case of bilateral otolith damage is reported, possibly caused by an inadvertent dural puncture, leading to a low pressure headache and vestibular issues.

## Contribution

The paper presents a novel case linking dural puncture to bilateral otolith damage and atypical vestibular symptoms.

## Key findings

- The patient experienced a low pressure headache and bilateral vestibular dysfunction following a dural puncture.
- The atypical presentation suggests a bilaterally asymmetrical insult to the otoliths.
- The case highlights a rare central insult resulting in peripheral otolithic pathology.

## Abstract

Introduction: This edition of the Audiology Research journal is dedicated to Dr. John Epley. For this reason, we would like to present a very unusual case involving the development of a bilateral abnormality of the otolith organs. The otoliths are the structures from which calcium particles detach to induce benign paroxysmal positional vertigo, the disorder for which Dr. Epley is famous for managing. Case report: This case report outlines an unusual presentation of vestibular pathology involving the otoliths. Discussion: We suggest that the atypical presentation may be related to a bilaterally asymmetrical insult to the otoliths. Conclusions: The central insult suffered by this patient resulted in bilateral peripheral otolithic pathology.