Efficacy of Levetiracetam in the Treatment of Sydenham Chorea

Background: To study the effect of levetiracetam in Sydenham chorea.

Methods: We retrospectively collected the data of 140 patients diagnosed with Sydenham chorea in the pediatric neurology and pediatric cardiology outpatient clinics of Van Training and Research Hospital between January 2010 and December 2018.

Results: There were 140 patients, 102 (70%) girls, with mean age of onset 11.8±2.7 years. Symptomatic treatment was initiated in all patients at the time of diagnosis; this medication was changed during follow-up in 15 patients. The most frequently prescribed drugs were haloperidol and Na valproate, and the most frequently discontinued one was haloperidol, due to side effects. The second-choice drug was most often levetiracetam. Clinical response often began within the first 2 weeks with Na valproate (p=0.002), within 4 weeks with carbamazepine (p=0.037) but 1-6 months with haloperidol (p=0.018) and levetiracetam (p=0.008). Time to full remission was similar with Na valproate, carbamazepine, haloperidol and levetiracetam (p=0.276). Our study indicated that levetiracetam was as effective as the other commonly used drugs in the symptomatic treatment of Sydenham chorea.

Conclusion: Levetiracetam might be an option in the treatment of Sydenham chorea because of an acceptable effect and safety profile. This observation needs further support by evidence obtained through controlled and blinded trials.