CHOREIFORM MOVEMENTS ASSOCIATED WITH THE USE OF VALPROATE

Objective: To describe the association of choreiform movements with the use of valproic acid. Design: Case series. Patients: Three patients who developed chorea during longterm treatment with valproic acid. All patients had severe brain damage; one had a preexisting unilateral vascular lesion in the caudate nucleus. At the time chorea developed, two patients were also receiving phenytoin sodium. Results: Chorea developed between 30 minutes and 3 hours after ingestion of valproic acid, and the duration of the episodes varied between 30 minutes and 8 hours. The episodes of chorea occurred frequently for several days followed by asymptomatic periods lasting several weeks. Choreic movements involved the head, mouth, tongue, trunk, and limbs bilaterally in two cases and con