Case ReportsA New Alternative Drug With Fewer Adverse Effects in the Treatment of Sydenham Chorea Levetiracetam Efficacy in a ChildŞahin, Sevim MD; Cansu, Ali MDAuthor Information Department of Pediatric Neurology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. Address correspondence and reprint requests to Sevim Şahin, MD, Department of Pediatric Neurology, Faculty of Medicine, Karadeniz Technical University, 61000 Trabzon, Turkey. E-mail: [email protected] Conflicts of Interest and Source of Funding: The authors have no conflicts of interest to declare. Clinical Neuropharmacology: July/August 2015 - Volume 38 - Issue 4 - p 144-146 doi: 10.1097/WNF.0000000000000084 Buy Metrics Abstract Levetiracetam (LEV) efficacy in the treatment of chorea in Huntington disease, paroxysmal nonkinesigenic dyskinesia, paroxysmal kinesigenic choreoathetosis, and dyskinetic cerebral palsy was reported in some studies. We described a case of a child with Sydenham chorea treated with LEV. A 7.5-year-old male patient presented with chorea, orofacial dyskinesia, speech impairment, and irritability. Echocardiographic examination revealed mitral insufficiency. Sydenham chorea was diagnosed after excluding other diseases causing chorea. Although his choreiform movements were decreased substantially with haloperidol treatment, speech impairment, orofacial dyskinesia, and light chorea were continued. Therefore, on day 9, LEV was added, and his complaints resolved in a few days. The severity of the chorea according to the Universidade Federal de Minas Gerais Sydenham's Chorea Rating Scale decreased from 47 to 5 points after LEV treatment. Thus, on day 13, the dose of haloperidol was reduced and gradually discontinued within 4 days. Symptoms did not reoccur. The follow-up at 1.5 months revealed recurrence of complaints due to discontinuation of LEV by parents. Signs and symptoms were regressed completely within 1 week after LEV retreatment. We suggest that LEV with fewer adverse effects comparing to other drugs may be considered to be a good alternative in the treatment of Sydenham chorea. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.