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Vim stimulation in Holmes' tremor secondary to subarachnoid hemorrhage
Göksemin Acar1, Feridun Acar, Levent Sinan Bir
1Department of Neurology, Pamukkale University, Denizli, Turkey. goksemind@yahoo.com
Objective And Importance:
Vim stimulation is effective in Parkinsonian and essential tremor. Our aim is to prove that it is also effective in other complex tremor syndromes such as Holmes' tremor.
Clinical Presentation:
A 31-year-old previously healthy man developed resting, action, and postural tremor in bilateral upper extremities and orolingual region, which was suggestive of Holmes' tremor, occurring 25 days after a subarachnoid hemorrhage. The initial pharmacotherapy was unsuccessful, including levodopa, bromocriptine, and levetiracetam.
Intervention:
Bilateral Vim stimulation suppressed both extremity and orolingual tremors which interfered with daily living activities such as eating and swallowing.
Conclusion:
Thalamic Vim stimulation seems to be a good treatment option in medically intractable complex tremor syndromes.
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