Figure 1
Time course of medication trials and chorea severity association. Note: timeline is for visual aid only and not to scale.
Table 1
Pooled Abstracts/Characteristics of Lamotrigine Associated Chorea.
| CASE | AGE/GENDER | LAMOTRIGINE DOSE | CHOREA ONSET | CHOREA RESOLVED | OTHER MEDICATIONS | ADDITIONAL NEUROLOGIC HISTORY | FOLLOW-UP/OUTCOME |
|---|---|---|---|---|---|---|---|
| Das KB, et al., 2003 [9] | 8/M | 8 mg/kg/d | Unclear | 3 wk | Valproate ‡ | Seizures | Asymptomatic after 4 years |
| Zesiewicz TA, et al., 2006 [3] | 52/M | 100 mg/d | 2 d | 2 wk | Phenytoin § Citalopram | Seizures DepressionNarcolepsy | NR |
| Miller MA, et al., 2008 | 23/M | Level 63.9 µg/mL * | 2 hr † | 12 hr | ║ | Bipolar disorder | NR |
| New case | 58/F | 325 mg/d | Unclear | ~ 2–3 mo. | Bupropion Duloxetine Gabapentin Trazadone | Schwannoma #, Meningioma #, migraine HA, Bipolar disorder, CN palsy ** | Lamotrigine restarted (lower dose) Mild chorea present |
[i] d indicates day; wk-weeks; hr- hours, mo.- months; NR- not reported; HA- headache; CN- cranial nerve.
* Level obtained 4 hours after admission; † Indicates hours after subsequent overdose.
‡ Valproate weaned, patient on lamotrigine monotherapy at time of chorea onset.
§ Phenytoin discontinued several weeks prior to starting lamotrigine and chorea onset.
║ Additional medications not reported; # Surgically removed; ** CN V, VII, VIII palsy.
Supplementary Figure 1 Flow Diagram of Literature Case Abstraction. The following steps were taken to review the cases of lamotrigine-associated chorea in the literature.