Question:medium
Drug of choice for resistant rheumatic chorea?
Drug of choice for resistant rheumatic chorea?
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Prefer the anticonvulsant over neuroleptics for resistant chorea in children.
Updated On: Jun 23, 2026
- Valproate
- Haloperidol
- Diazepam
- Probenecid
Show Solution
The Correct Option is A
Solution and Explanation
Step 1: Frame the problem. Sydenham chorea from rheumatic fever often will not settle with anti-inflammatory rheumatic therapy, so we treat the movements directly when they are severe or resistant.
Step 2: The two symptomatic drug families are anticonvulsants (valproate, carbamazepine) and dopamine-blocking neuroleptics (haloperidol, pimozide, risperidone).
Step 3: In a child with resistant chorea, sodium $\text{valproate}$ is preferred first because it controls the involuntary movements well while avoiding the extrapyramidal and sedative burden of neuroleptics.
Step 4: Eliminate the rest: haloperidol is reserved as backup, diazepam only gives mild non-specific relief, and probenecid is purely a uricosuric for gout and is irrelevant here.
Step 5: The drug of choice for resistant rheumatic chorea is valproate.\[\boxed{\text{Valproate}}\]
Step 2: The two symptomatic drug families are anticonvulsants (valproate, carbamazepine) and dopamine-blocking neuroleptics (haloperidol, pimozide, risperidone).
Step 3: In a child with resistant chorea, sodium $\text{valproate}$ is preferred first because it controls the involuntary movements well while avoiding the extrapyramidal and sedative burden of neuroleptics.
Step 4: Eliminate the rest: haloperidol is reserved as backup, diazepam only gives mild non-specific relief, and probenecid is purely a uricosuric for gout and is irrelevant here.
Step 5: The drug of choice for resistant rheumatic chorea is valproate.\[\boxed{\text{Valproate}}\]
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