Holmes' Tremor Caused By Coexisting Parkinson'S Disease In A Case Of Spinocerebellar Ataxia Type 31

Holmes' tremor is a low-frequency resting and intention tremor. Here, we report a case of spinocerebellar ataxia type 31 with an unusual presentation of Holmes' tremor. We traced it to the development of Parkinson's disease in the patient. L-dopa was insufficient for tremor, but zonisamide and ventralis intermedius thalamotomy were effective. Both cerebellar and dopaminergic system damage are thus required to express Holmes' tremor.