Pit Viper Venom Now Tested for Stroke at Erlanger

The venom of a Malaysian pit viper may hold the key to the remarkable recovery of a North Georgia woman who suffered a massive stroke.

Last September Carolyn Stephens was having dinner and watching TV with her husband in their Trenton, Ga. home. “All of a sudden I felt like the room was moving, so I bowed my head and closed my eyes,” she said. When she raised her head, the room was still spinning, and Mrs. Stephens recalled seeing “10 to 15 TV screens” in front of her.

Alarmed, Joseph “Ed” Stephens knew something was wrong but didn’t want his wife to panic. “Her eyes were rolling around and her mouth was twisted, so I asked her if she was alright,” he related. When his wife said no, he got her up and onto a couch. Then he called 911.

Paramedics rushed Mrs. Stephens to a local hospital. When it was determined that Mrs. Stephens had indeed suffered a stroke, she was immediately transferred to the region’s only accredited stroke center at Erlanger.

“I remember someone talking to me when I was in the emergency room, asking if I could move my leg,” recalled Mrs. Stephens, who said she “could hear them, but couldn’t do anything.” These were the last words she remembered until waking up in an Erlanger intensive care unit.

She then learned her husband had signed consent forms to enroll his wife in a clinical trial, now in the final stage of a double-blind study. Local neurologist, Dr. Tom Devlin, was a lead investigator in this nationwide study. The unlikely new weapon being tested against stroke? The venom of a Malaysian pit viper.

From lethal to life-saving

Researchers who had been studying survivors of pit viper bites discovered years ago that the blood of those victims was extremely thin and did not seem to clot. This discovery had intrigued the scientific community for years; many felt that the way the snake’s venom kills people should also be able to help those who need fast-acting blood thinners to survive. Since 80% of strokes stem from blood clots - which cut off blood flow to the brain causing brain tissue to die – researchers decided to test their theories in a worldwide study. Launched in November 2005, this Viprenex study was designed to determine whether or not infusing selected parts of Malaysian pit viper venom into some patients could stop a stroke in its tracks.

To benefit from any form of stroke treatment, time is of the essence. Among the leading drugs currently available to stop a brain attack is tPA, tissue plasminogen activator, which must be administered within three hours from the onset of stroke. The study of Viprinex can give doctors twice as much time – six hours – to treat stroke. This extra time is extremely important because most people don’t respond quickly enough to the symptoms of stroke, according to Dr. Devlin. Many people ignore warning signs of stroke and often wait days before seeking treatment for themselves or a loved one, he explains.

When Mrs. Stephens arrived at Erlanger last fall, she was considered an ideal candidate for the Viprinex clinical trial. Although this was a double blind study, meaning no one knew whether or not she received the venom (or a placebo), her husband is convinced she received the Viprinex.

“I believe she got the venom,” he says. “It was a world of difference seeing her while she was having the stroke and the next day at Erlanger. Her face wasn’t screwed up anymore and she was talking normal. I want to say it’s a miracle.”

After a week at Erlanger, Mrs. Stephens spent 10 days undergoing speech and balance therapy at Siskin Rehabilitation Hospital. Occupational health programs at Siskin also helped the Trenton woman relearn how to cook.

Although his wife continues to go to Siskin for outpatient therapy, Mr. Stephens reports that she is “pretty much back to normal,” cooking again and wanting to drive. “I’ve had her for 43 years and want to keep her at least another 30,” he says.
Also delighted at Mrs. Stephens’ outcome and the treatment opportunities this study represents for future ischemic stroke victims is Dr. Devlin, medical director of the Erlanger Regional Stroke Center.

“With an internationally recognized stroke interventional team and a world class stroke research center involved in studies like this, Erlanger is now considered one of the leading stroke treatment centers in the country,” says the Chattanooga neurologist. “We just need to continue educating people about the symptoms of stroke, that ‘time is brain,’ and that when stroke is the diagnosis, Erlanger is the place to be,” he stressed.