Kleine-Levin syndrome

Epidemiology

• rare
• onset is typically around adolescence to the late teens
• 4 times more common in males than in females

Pathology

• basal frontal lobe dysfunction
• temporal lobe epilepsy
• septal nucleus injury
• hypothalamus areas regulating sleep & appetite may be involved

Clinical manifestations

• recurring periods of excessive drowsiness & sleep (up to 20 hours per day)
• symptoms may last for days to weeks
• excessive food intake
• irritability
• disorientation
• lack of energy
• phonophobia
• hallucinations (some)
• hypersexuality
• affected persons are normal between episodes
• depression & amnesia may occur after an attack (temporary)
• may be weeks or more before symptoms reappear

Differential diagnosis

• cyclic re-occurrence of sleepiness during the premenstrual period in teenaged girls

Management

• no definitive treatment
• stimulants, amphetamines, methylphenidate & modafinil may be useful to treat sleepiness
• lithium or carbamazepine may be useful for mood disorder
• responses to treatment have often been limited
• prognosis
  • appears to be benign
  • does not impact on intellect or physical function
  • symptoms usually improve or disappear with age

More general terms

• syndrome

Patient information

Kleine-Levin syndrome patient information