Successful treatment of rheumatic chorea with carbamazepine

Liora Harel*, Abraham Zecharia, Rachel Straussberg, Benjamin Volovitz, Jacob Amir

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Carbamazepine has been used successfully in the treatment of different movement disorders and was recently reported to be effective for nonhereditary chorea. In view of the significant side effects associated with the drugs currently used to treat chorea, we sought to further evaluate the efficacy of carbamazepine in children with rheumatic chorea. The study was prospective and included 10 children with chorea (eight females and two males; age range = 7-16 years) referred to our Pediatric Rheumatology Clinic between 1995 and 1999. Nine had rheumatic fever and one had antiphospholipid antibody syndrome that later evolved to systemic lupus erythematosus. All were treated with carbamazepine. Improvement was evident within 2-14 days of initiation of low doses of carbamazepine (4-10 mg/kg daily). The plasma drug levels were 2.8-8.2 μg/mL (therapeutic antiepileptic range = 8-12 μg/mL). The chorea disappeared within 2-12 weeks. The duration of treatment was 1-15 months. No side effects were observed. Recurrence was observed in three patients who received a second trial of carbamazepine with a good response. We suggest that carbamazepine may serve as a first-line treatment for rheumatic chorea. (C) 2000 by Elsevier Science Inc.

Original languageEnglish
Pages (from-to)147-151
Number of pages5
JournalPediatric Neurology
Issue number2
StatePublished - 2000


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