Narcolepsy is a chronic disorder characterized by excessive daytime sleepiness (EDS) and cataplexy, often triggered by stress, sleep disturbances, pregnancy, or trauma. Modafinil is a preferred treatment for EDS, known for improving quality of life, though long-term safety and efficacy data remain limited. This review was registered with PROSPERO (CRD420251136771). This systematic review and meta-analysis evaluated the effectiveness of Modafinil in treating narcolepsy. A comprehensive search of databases (PubMed, Embase, Google Scholar, Scopus, ScienceDirect, Web of Science) was conducted to identify cohort studies and randomized controlled trials (RCTs) up to August 2025. Efficacy outcomes included the Maintenance of Wakefulness Test (MWT) and Epworth Sleepiness Scale (ESS). Statistical analysis using Review Manager 5.4 compared Modafinil to placebo. The review aimed to reassess and synthesize existing randomized evidence rather than identify new efficacy trials. Of 4567 articles screened, nine studies were included in the systematic review, and five studies, involving 997 adult patients, were analyzed in the meta-analysis. Modafinil significantly improved MWT scores (MD = 3.56, 95% CI [2.25–4.86]) and reduced ESS scores (MD = −3.34, 95% CI [–4.13 to −2.56]). Moderate heterogeneity was observed but was reduced following pre-specified sensitivity analyses. These findings confirm the short-term efficacy of modafinil in reducing excessive daytime sleepiness based on legacy randomized controlled trials conducted primarily in the 1990s and early 2000s, while highlighting the absence of new eligible RCTs in the past decade. However, long-term efficacy and safety remain to be established, underscoring the need for larger, long-duration randomized trials.

Aim: Deep brain stimulation (DBS) involves implanting electrodes in specific brain areas. High-frequency Stimulation (HFS) and low-frequency Stimulation (LFS) target motor and non-motor symptoms differently. DBS is crucial in Parkinson's disease treatment for managing medication-resistant symptoms and improving quality of life. This review aims to evaluate the differential impact of high-frequency and low-frequency deep brain stimulation (DBS) on motor symptoms in Parkinson's disease (PD) patients. This systematic review adheres to PRISMA guidelines and focuses on clinical studies involving human subjects. Methods: Systematic search in electronic databases (PubMed, Google Scholar, Science Direct, Cochrane Collaboration Database of Randomized Trials) was performed to identify randomized controlled trials (RCTs) up to 13th July 2024. Results: Among 126 pooled patients from 8 RCTs, it was found that LFS significantly improved gait stability, swallowing, and verbal fluency with minimal adverse effects. Conversely, HFS was effective in reducing rigidity and tremor but was associated with potential side effects such as gait and speech impairment. Conclusion: The review highlights the nuanced effects of STN-DBS frequencies in Parkinson's treatment, suggesting high-frequency improves rigidity and tremor but may cause side effects, while low-frequency enhances gait stability and speech, necessitating further research for optimized, patient-specific therapies.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder marked by progressive motor neuron loss, muscle weakness, and respiratory failure

Wernicke’s Encephalopathy (WE) is a metabolic disorder caused by thiamine deficiency, most commonly linked to chronic alcohol use. It typically presents with a triad of ataxia, mental confusion, and oculomotor abnormalities, with classic MRI findings showing symmetric hyperintensities in the mammillary bodies, thalamus, and periaqueductal region. The authors report a case of a 55-year-old male with WE presenting atypical unilateral thalamic hyperintensities on MRI, initially misdiagnosed as ischemic stroke. Delayed thiamine supplementation led to significant clinical improvement and resolution of atypical findings, with subsequent emergence of traditional bilateral WE changes on MRI. This case emphasizes the importance of early thiamine therapy and demonstrates that treatment can still be beneficial even when delayed.