Harel L, Zecharia A, Straussberg R, Volovitz B, Amir J
Department of Pediatrics "C", Schneider Children's Medical Center of Israel, Sackler School of Medicine; Tel Aviv University;, Petach Tikvah, Israel.
Pediatr Neurol. 2000 Aug;23(2):147-51. doi: 10.1016/s0887-8994(00)00177-6.
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 microg/mL (therapeutic antiepileptic range = 8-12 microg/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.
卡马西平已成功用于治疗不同的运动障碍，最近有报道称其对非遗传性舞蹈病有效。鉴于目前用于治疗舞蹈病的药物存在显著副作用，我们试图进一步评估卡马西平对风湿性舞蹈病患儿的疗效。该研究为前瞻性研究，纳入了1995年至1999年间转诊至我们儿科风湿病诊所的10名舞蹈病患儿（8名女性和2名男性；年龄范围为7至16岁）。其中9名患有风湿热，1名患有抗磷脂抗体综合征，该综合征后来发展为系统性红斑狼疮。所有患儿均接受卡马西平治疗。在开始低剂量卡马西平（每日4至10毫克/千克）治疗后的2至14天内，病情明显改善。血浆药物水平为2.8至8.2微克/毫升（抗癫痫治疗范围为8至12微克/毫升）。舞蹈病在2至12周内消失。治疗持续时间为1至15个月。未观察到副作用。3名接受第二次卡马西平试验且反应良好的患者出现了复发。我们建议卡马西平可作为风湿性舞蹈病的一线治疗药物。
