Effect of zonisamide on post-traumatic Holmes’ tremor

Abstract

Holmes’ tremor is a rare symptom characterized by a complex combination of resting, postural and intention tremor. A 66-year-old right-handed man post-traumatically developed severe action tremor in his right hand, which had a component of the re-emergent type and predominantly involved proximal muscles. He also presented mild resting tremor in his right hand. As the response of levodopa/carbidopa and arotinolol was limited, he started zonisamide, which resulted in dramatic improvement. The Fahn–Tolosa–Marin Tremor Rating Scale motor score improved from 52 points to 24 points. In conclusion, zonisamide could be a therapeutic option for post-traumatic Holmes’ tremor. Further prospective studies are required.