Question:
What is the line of treatment for intractable Sydenham chorea?
What is the line of treatment for intractable Sydenham chorea?
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The drug of choice enhances GABA action rather than blocking dopamine.
Updated On: Jun 23, 2026
- Haloperidol
- Valproate
- Warfarin
- Risperidone
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The Correct Option is B
Solution and Explanation
Step 1: Sydenham chorea (also called chorea minor, rheumatic chorea or St. Vitus' dance) is a major diagnostic criterion of rheumatic fever and the most common acquired chorea of childhood. It causes rapid, uncoordinated jerking movements of the face, hands and feet.
Step 2: The mainstay of pharmacological control is enhancement of GABA-mediated inhibition. Valproate boosts GABA activity and is the preferred agent for intractable or troublesome chorea; benzodiazepines, which also facilitate GABA, are a recognised alternative.
Step 3: Dopamine antagonists such as haloperidol and risperidone can suppress chorea but carry a higher risk of extrapyramidal side effects, so they are not the first choice for intractable disease. Warfarin is an anticoagulant with no role in chorea. The best answer is option (b), Valproate.
Step 2: The mainstay of pharmacological control is enhancement of GABA-mediated inhibition. Valproate boosts GABA activity and is the preferred agent for intractable or troublesome chorea; benzodiazepines, which also facilitate GABA, are a recognised alternative.
Step 3: Dopamine antagonists such as haloperidol and risperidone can suppress chorea but carry a higher risk of extrapyramidal side effects, so they are not the first choice for intractable disease. Warfarin is an anticoagulant with no role in chorea. The best answer is option (b), Valproate.
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