Bouchal Siham, Ouali Ouarda, Belahsen Mouhamed Faouzi
Service de Neurologie, CHU Hassan II, Fès, Maroc.
Pan Afr Med J. 2017 Jul 20;27:212. doi: 10.11604/pamj.2017.27.212.11383. eCollection 2017.
Sydenham's chorea is the most common acquired cause of chorea in the third world. We report a case of recurrent chorea successfully treated with sodium valproate. Miss A.C, aged 16, with a history of recurrent angina reported an episode of choreic movements 2 years before requiring treatment with haloperidol and prevention of rheumatic fever. The patient interrupted her treatment with occurrence of a relapse a few months later. Brain MRI and transthoracic ultrasound were normal. Preventive treatment with extencilline and haloperidol was restarted without any improvement, hence the treatment with sodium valproate. The patient responded very well after 2 months of treatment, without recurrence at 3 years' follow-up. The treatment of Sydenham's chorea was based on neuroleptics. Recent studies advocate the use of other more effective and better tolerated molecules.
西德纳姆舞蹈病是第三世界国家舞蹈病最常见的后天性病因。我们报告一例复发性舞蹈病患者,使用丙戊酸钠成功治愈。A.C.小姐,16岁,有复发性心绞痛病史,在需要使用氟哌啶醇治疗并预防风湿热的2年前出现了一段舞蹈样动作。患者在几个月后复发,中断了治疗。脑部MRI和经胸超声检查均正常。重新开始使用长效西林和氟哌啶醇进行预防性治疗,但没有任何改善,因此改用丙戊酸钠治疗。治疗2个月后患者反应良好,随访3年无复发。西德纳姆舞蹈病的治疗过去基于抗精神病药物。最近的研究提倡使用其他更有效且耐受性更好的药物。