Dose-dependent improvement of myoclonic hyperkinesia due to Valproic acid in eight Huntington's Disease patients: a case series

Table 2 Clinical data and co-medication before and after treatment

Patient	Initial UHDRS motor score	Second UHDRS motor score	Valproic acid (mg/day)	Valproic acid serum level (μg/ml)	Mood stabiliza-tion	Improve-ment of mobility and manual dexterity	Changes in co-medication in mg
Case 1	80	72	900	30	+++	+	T100 CBZ900 MEL37.5 TE⇔, LO⇔ CL25
Case 2	65	33	1200	87	-	+++	R⇔
Case 3*	79	61	1800	59	+	+	T100 CL44 CLO0.5 LEV1000 TE⇔ CBZ400
Case 3*	84	74	2700	43	++	++	T300 TE25 CLO0.5 CL⇔ CBZ400
Case 4	56	56	300	(ND)	-	-	T⇔, TE⇔, LO⇔, OX⇔, HAL⇔
Case 5	72	66	900	73	++	+	T⇔, HAL⇔
Case 6	74	60	1050	43	+++	++	T150 TE25 S200 Q⇔
Case 7	57	50	1950	84	+	+++	T300 LO1.5
Case 8	91	70	1350	56	++	++	T50 LO⇔, Q⇔, MEL⇔

Clinical data and co-medication before (initial UHDRS motor score) and after (second UHDRS motor score) treatment with valproic acid. ND = no data; Intensity: - = no, + = mild, ++ = moderate, +++ = very good. Medication: T = Tiaprid, TE = Tetrabenazine, CBZ = Carbamazepine, CL = Clozapine, CLO = Clonazepam, MEL = Melperone, LO = Lorazepam, R = Rilutek, LEV = Levetiracetam, OX = Oxazepam, HAL = Haloperidol, S = Sulpride, Q = Quetiapin. Signs: Increase = , decrease = no change = ⇔. One patient (*) was treated twice with an increased dose of valproic acid within a 4 year period, see text.

ISSN: 1471-2377