[The efficiency of carbamazepine in a case of post-streptococcal hemichorea]
M A Hernández-Latorre1, M Roig-Quilis
1Servicio de Neuropediatría, Hospital de Niños de Barcelona, Barcelona, España.
Insights
Carbamazepine effectively treated a child with Sydenham's chorea (SC), a disabling neurological disorder. This medication led to symptom remission within six weeks, with no observed side effects during a nine-month follow-up.
Area of Science:
- Pediatric Neurology
- Movement Disorders
Background:
- Sydenham's chorea (SC) is the primary cause of chorea in children, despite declining rheumatic fever rates.
- SC is typically benign and self-limiting but can be disabling and last for months.
- Various symptomatic treatments exist, including corticosteroids, haloperidol, valproic acid, and carbamazepine, each requiring evaluation for efficacy and tolerability.
Observation:
- A case of SC developing over three months in a pediatric patient is presented.
- Treatment with carbamazepine was initiated for the patient.
- The patient was monitored for nine months post-treatment.
Findings:
- Carbamazepine demonstrated efficacy by the tenth day of treatment.
- Complete remission of chorea symptoms was achieved within six weeks.
- No relapses or adverse side effects were noted during the nine-month follow-up period.
Implications:
- This case provides evidence for carbamazepine as a potential first-line treatment for Sydenham's chorea.
- Carbamazepine offers a well-tolerated and effective therapeutic option for pediatric chorea.
- Further research into carbamazepine's role in managing pediatric movement disorders is warranted.
Introduction:
Chorea is an infrequent disorder at the paediatric age which has a number of both hereditary and acquired causes. Post-streptococcal or Sydenham's chorea (SC) is still the main cause of chorea in children, in spite of the drop in prevalence of rheumatic fever in the last few years. SC is a benign, self-limiting disorder, but may last for several months and can be highly disabling. Several different types of symptomatic treatment have been proposed, for example corticoids, haloperidol, valproic acid, and carbamazepine. In each case, both the speed with which the clinical improvement is brought about, and the degree to which they are tolerated and the absence of side effects must be evaluated.
Case Report:
We present a new case of SC that had been developing for three months. Carbamazepine was effective from the tenth day onwards and total remission of the symptoms was achieved in six weeks. Total follow-up time was nine months, and in this time no relapses or side effects were observed.
Conclusions:
This contribution offers new evidence supporting carbamazepine as another first choice medication in the treatment of this type of chorea.
