Reactions 1380 - 3 Dec 2011

★ STetrabenazine

Quadriparesis and dysarthria (first reports) in achild: case report

A 7-year-old girl developed quadriparesis and dysarthriaduring treatment with tetrabenazine for rheumatic chorea.

The girl was admitted with excessive sleepiness for1 day, weakness of all four limbs for 8 hours, and inabilityto speak for 4 hours. She had been diagnosed withrheumatic chorea 2 days previously, and had been startedon treatment including tetrabenazine 100 mg/day in3 divided doses [route not stated]. On examination, shewas unable to vocalise. In all four limbs, her tone wasdecreased, and power was 2/5. Cranial nerve examinationwas normal, abdominal reflex was present, deep tendonreflexes were normal in all limbs and there was no truncalweakness. Her plantars were flexor bilaterally, and therewere no involuntary movements or meningeal signs. Shehad received the last tetrabenazine dose 9 hours earlier. Atetrabenazine adverse event was suspected based on herhistory and examination findings.

One hour after admission, the girl started vocalising.Power gradually increased in all four limbs, and she wasable to walk within 18 hours. When involuntarymovements reappeared, she refused tetrabenazine, andhaloperidol was started. She was discharged 2 days later.Zaki SA, et al. Quadriparesis and dysarthria due to tetrabenazine therapy in a childwith rheumatic chorea. Indian Journal of Pharmacology 43: 601-602, No. 5, Sep-Oct 2011. Available from: URL: http://dx.doi.org/10.4103/0253-7613.84982 -India 803063450

» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports ofquadriparesis or dysarthria associated with tetrabenazine.The WHO ADR database contained 1 report of quadriparesisand 9 reports of dysarthria associated with tetrabenazine.

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Reactions 3 Dec 2011 No. 13800114-9954/10/1380-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved