A 6-year-old boy with benign familial chorea diagnosed at 1 year and ADHD evaluated and treated with methylphenidate (MPH) at 6 years is reported from the Department of Pediatrics, David Grant Medical Center, Travis Air Force Base, California. After MPH beginning with 2.5 mg BD and gradually increasing to 7.5 mg BD, his attention span, self-control, handwriting, and school performance were benefited as expected, but in addition, the chorea improved and his independent walking skills developed. On drug holidays, the chorea and gait problems regressed. [1]
COMMENT. The author suggests that chorea complicating ADHD should not contraindicate a cautious trial of stimulant medication. If methylphenidate improves a child’s performance in school and lessens stressful situations, it may also result in a reduction in chorea and improved motor abilities.