From the Research
Treatment Options for Choreoathetosis
- The treatment for choreoathetosis may involve the use of medications such as levetiracetam, which has been shown to be effective in eliminating paroxysmal events in patients with paroxysmal kinesiogenic choreoathetosis 1.
- Inhibitors of presynaptic vesicular monoamine transporter type 2 (VMAT2), such as tetrabenazine, deutetrabenazine, and valbenazine, are considered the treatment of choice for patients with chorea 2.
- Dopamine receptor blockers, anti-epileptics, and anti-glutamatargics may also be used to treat choreoathetosis 2.
- Deep brain stimulation, specifically bilateral pallidal deep brain stimulation, may be an effective treatment option for patients with dystonia-choreoathetosis cerebral palsy, particularly those with little spasticity and only slight abnormalities of the basal ganglia on MRI 3.
Specific Treatment Approaches
- Levetiracetam has been shown to be effective in treating Sydenham chorea, with fewer adverse effects compared to other drugs 4.
- Bilateral pallidal deep brain stimulation has been shown to improve the severity of dystonia-choreoathetosis, functional disability, pain, and mental health-related quality of life in patients with dystonia-choreoathetosis cerebral palsy 3.
- Local injections of botulinum toxin may help reduce pain and limit the amplitude of some movements in patients with dystonia-choreoathetosis cerebral palsy 5.
Considerations for Treatment
- The choice of therapy for choreoathetosis should be guided by the main clinical features, the experience of experts, and the results of open-label trials and controlled studies 5.
- Treatment should be started at a low dose and increased slowly, with more beneficial effects obtained on upper extremity function, face and jaw dystonia, and drooling, particularly in children 5.