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Modafinil-Induced Hyperkinetic Movements in Post-Stroke Patients: A Case Series
Mahendra Javali1, Anish Mehta1, Chandrashekhar Enuguri1
1Department of Neurology, Ramaiah Medical College and Hospitals, Ramaiah University of Applied Sciences, Bengaluru, India.
Background:
Modafinil is a wakefulness-promoting agent used off-label for post-stroke hypersomnolence. Although generally well-tolerated, rare central nervous system adverse effects, including hyperkinetic movement disorders, have been reported.
Cases:
We describe three elderly male stroke patients who developed new-onset involuntary movements within 48 h of initiating modafinil (100 mg/day) during recovery. Movements were choreiform or irregular, present during wakefulness, and absent during sleep. Extensive metabolic, neuroimaging, and electrophysiological evaluations revealed no alternative cause. Symptoms resolved completely within 36-48 h of discontinuing modafinil.
Conclusions:
Modafinil may rarely induce reversible hyperkinetic movements in elderly stroke patients. Clinicians should monitor for abnormal movements during its use, particularly in neurologically vulnerable individuals.
Insights
Modafinil, used for stroke-related sleepiness, may rarely cause involuntary movements in elderly patients. These hyperkinetic movements are reversible upon discontinuing the medication.
Area of Science:
- Neurology
- Pharmacology
Background:
- Modafinil is a wakefulness-promoting agent prescribed off-label for post-stroke hypersomnolence.
- While generally safe, rare central nervous system adverse effects like hyperkinetic movement disorders have been associated with modafinil use.
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