1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-8-63-c 10.15844/pedneurbriefs-8-8-12 Movement Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Choreiform Movements and Valproic Acid http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 08 1994 01 06 2016 8 8 63 64 Copyright: © 1994 The Author(s) 1994 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Choreiform movements associated with the use of valproate

Three patients, aged 10, 17, and 36 years, who developed chorea during long-term treatment with valproic acid are reported from the Comprehensive Epilepsy Program, Bowman Gray School of Medicine, Winston-Salem, NC.

 Valproic Acid Chorea Divalproex Sodium Sprinkles

Three patients, aged 10, 17, and 36 years, who developed chorea during long-term treatment with valproic acid are reported from the Comprehensive Epilepsy Program, Bowman Gray School of Medicine, Winston-Salem, NC. All patients had severe brain damage, one had a vascular lesion in the caudate nucleus, and two were also receiving phenytoin. Chorea developed within 1/2 to 3 hours of valproic acid ingestion and lasted 1/2 to 8 hours. Movements were not relieved by phenytoin withdrawal. Chorea resolved when valproic acid was withdrawn in one patient and replaced by divalproex sodium sprinkles in the other two. [1]

COMMENT. Valproate-induced chorea in these patients appeared to be dose related, occurring at peak serum concentrations. The use of divalproex sodium sprinkles avoided the excessive fluctuations of serum levels seen with valproic acid and movements were controlled. Choreoathetosis is a known side effect of the majority of antiepileptic drugs. This may be the first recorded case of valproate-induced chorea.

 Lancman ME Asconape JJ Penry JK Choreiform movements associated with the use of valproate Arch Neurol 1994 Jul 51 7 702 704 10.1001/archneur.1994.00540190086020 8018044