Question

What is the line of treatment for intractable Sydenham chorea?

• A. Haloperidol
• B. Valproate
• C. Warfarin
• D. Risperidone

Answer 1

The Correct Option is B

Intractable Sydenham chorea is a rare neurological disorder associated with rheumatic fever. It involves involuntary, rapid, irregular movements often affecting the face, hands, and feet. When treating this condition, especially when it's resistant to initial therapy, it is crucial to select an appropriate medication that addresses both the symptoms and underlying causes.

Among the options provided:

• Haloperidol: An antipsychotic that can be used for managing chorea but may not be the first-line treatment due to side effects.
• Valproate: A mood stabilizer and anticonvulsant that is effective in reducing chorea symptoms by enhancing GABA-mediated inhibition.
• Warfarin: An anticoagulant, irrelevant as a direct treatment for chorea.
• Risperidone: An antipsychotic similar to haloperidol, again not first-line for intractable cases.

Considering the pharmacological profiles and specific efficacy towards symptoms of Sydenham chorea, Valproate emerges as the preferred choice. It helps manage the involuntary movements more effectively in resistant cases, providing better control with a relatively favorable side effect profile compared to other antipsychotics.