Clinical study on anti-epileptic drug with B vitamins for the treatment of epilepsy after stroke.

OBJECTIVE To study the clinical value of anti-epileptic drugs combined with B vitamins in the treatment of epilepsy after stroke. PATIENTS AND METHODS The study included 90 consecutive patients with epilepsy after stroke. Patients were randomly divided into groups of 30 each according to treatment: single-agent or combination anti-epileptic therapy with oxcarbazepine and sodium valproate (control group), anti-epileptic therapy with compound vitamin B tablets (observation group 1), and anti-epileptic therapy with vitamin B12 (mecobalamin) (observation group 2). After 12 months, treatment effects were assessed and compared among groups. RESULTS Compared with the control group, observation group 2 had better epilepsy control and observation group 1 had no difference in efficacy. New-onset stroke was seen in three cases (10%) of the control group and in two cases (6.7%) of observation group 1. This was not seen in observation group 2. In the control group and observation group 1, National Institutes of Health Stroke Scale (NIHSS) score significantly decreased after 6 months, but increased again at 12 months. Conversely, NIHSS score continuously decreased during follow-up in observation group 2. The plasma level of asymmetric dimethyl arginine (ADMA) gradually increased in the control group and observation group 1, but remained unchanged in observational group 2. The differences in NIHSS scores and plasma ADMA levels between the control and observation groups were statistically significant. CONCLUSIONS Anti-epilepsy drugs combined with B vitamins can improve epilepsy control after stroke and reduce new stroke occurrence. This effect may be associated with stability of plasma ADMA levels. Vitamin B12 may be better than vitamin B complex in the treatment of epilepsy after stroke.