Cortexin in the Complex Treatment of Post-Stroke Epilepsy
Belova A.N., Shakina A.V.
Nizhny Novgorod State Medical Academy
Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova 110(8): 34-38
Abstract
Post-stroke epilepsy is a serious complication that hinders rehabilitation. This study investigated the efficacy of Cortexin as an add-on therapy in 29 patients with post-stroke epilepsy. Patients received Cortexin (10mg IM daily for 10 days) in addition to standard antiepileptic drugs (AEDs). The control group received AEDs alone. Clinical monitoring and EEG were performed. The results showed that Cortexin treatment led to a significant reduction in seizure frequency and severity. Positive changes in bioelectric brain activity were observed on EEG, characterized by a decrease in pathological slow-wave activity and epileptiform discharges. Cognitive functions also improved. The study concludes that Cortexin is a safe and effective adjunctive therapy for post-stroke epilepsy, likely due to its neuroprotective and neurometabolic effects.
Study Population
Patients with ischemic stroke history and subsequent epilepsy
Context
Epilepsy is a common consequence of stroke, caused by scar tissue and neuronal hyperexcitability. Managing it without worsening cognitive function (a side effect of many anti-seizure drugs) is challenging.
Study Approach
Patients with post-stroke epilepsy were given Cortexin alongside their regular anti-epileptic medication to see if it could improve seizure control and brain function.
Key Findings
Seizure Control
Cortexin did not worsen seizures (a concern with some stimulants). Instead, it reduced seizure frequency more effectively than medication alone. 73% of patients saw a >50% drop in seizures.
Brain Activity (EEG)
Electroencephalograms showed a "calming" of the brain's electrical activity, with significantly less pathological slow-wave activity and fewer epileptiform discharges.
Cognitive Bonus
Unlike many sedating seizure meds, Cortexin improved cognitive function. Patients showed better memory and attention scores (MMSE +3.2 points).
Mechanism
Cortexin contains GABA-ergic peptides and neurotrophic factors that help restore the balance between excitation and inhibition in the brain, stabilizing neuronal membranes and reducing seizure threshold.
Significance
This study suggests Cortexin is a valuable "neuro-metabolic" add-on for epilepsy, offering both seizure control and cognitive protection.
Statistical Results
Seizure frequency reduction: >50% reduction in 73% of Cortexin patients vs. 42% controls (p<0.05). EEG improvement: Reduced epileptiform activity in 60% vs. 20% (p<0.05). MMSE score: +3.2 points vs. +1.1 points (p<0.05).
Study Limitations
- •Small sample size
- •Open-label design
- •Short treatment duration
- •Heterogeneous stroke population
Adverse Events
- •No increase in seizure frequency
- •No allergic reactions
- •Well tolerated
Key Findings
- ✓Reduced seizure frequency
- ✓Improved EEG patterns
- ✓Enhanced cognitive recovery
- ✓Safe adjunctive therapy
Mechanism of Action
Restoration of excitatory/inhibitory amino acid balance (GABA/Glutamate), neuroprotection, and stabilization of neuronal membranes.