Vim stimulation in Holmes' tremor secondary to subarachnoid hemorrhage.

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.