Question

What is the line of treatment for intractable Sydenham chorea?

• A. Haloperidol
• B. Valproate
• C. Warfarin
• D. Risperidone

Answer 1

The Correct Option is B

Step 1: Sydenham chorea is the neurological face of acute rheumatic fever, marked by restless, dance-like involuntary movements. The pharmacological goal is to calm the overactive movement circuitry.

Step 2: Agents that strengthen the brain's main inhibitory transmitter, GABA, dampen the chorea. Valproate raises GABA-ergic activity and is the go-to drug when the chorea will not settle.

Step 3: The neuroleptics (haloperidol, risperidone) act by blocking dopamine and can be used, but their movement-disorder side effects make them second choices. Warfarin is irrelevant as it only thins blood.

\[\boxed{\text{Valproate}}\]