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.