Kleine-Levin syndrome: a case report

Neto, Octávio da Silveira; Silveira, Octavio A. Da

doi:10.1590/s0004-282x1991000300017

Cited by 6 publications

(1 citation statement)

References 18 publications

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“…Immunoelectrophoresis of the CSF was performed and found to be normal in four patients. This excludes the possibility of frequent oligoclonal secretion of antibodies as observed in multiple sclerosis, another remittent neurological disease (Billard et al, 1978;Powers and Gunderman, 1978;Da Silveira Neto and Da Silveira, 1991;Pike and Stores, 1994). CSF levels of serotonin and a serotonin metabolite were increased (five times and twice the normal values, respectively) in one patient (Koerber et al, 1984), but not in four other patients, as were dopamine and norepinephrine metabolite levels (Carpenter et al, 1982;Hart, 1985;Hasegawa et al, 1998;Landtblom et al, 2002).…”

Section: Cerebrospinal Fluid Analysismentioning

confidence: 85%

Kleine–Levin syndrome: a systematic review of 186 cases in the literature

Arnulf¹,

Zeitzer²,

File³

et al. 2005

Brain

372

300

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Kleine-Levin syndrome (KLS) is a rare disorder with symptoms that include periodic hypersomnia, cognitive and behavioural disturbances. Large series of patients are lacking. In order to report on various KLS symptoms, identify risk factors and analyse treatment response, we performed a systematic review of 195 articles, written in English and non-English languages, which are available on Medline dating from 1962 to 2004. Doubtful or duplicate cases, case series without individual details and reviews (n = 56 articles) were excluded. In addition, the details of 186 patients from 139 articles were compiled. Primary KLS cases (n = 168) were found mostly in men (68%) and occurred sporadically worldwide. The median age of onset was 15 years (range 4-82 years, 81% during the second decade) and the syndrome lasted 8 years, with seven episodes of 10 days, recurring every 3.5 months (median values) with the disease lasting longer in women and in patients with less frequent episodes during the first year. It was precipitated most frequently by infections (38.2%), head trauma (9%), or alcohol consumption (5.4%). Common symptoms were hypersomnia (100%), cognitive changes (96%, including a specific feeling of derealization), eating disturbances (80%), hypersexuality (43%), compulsions (29%), and depressed mood (48%). In 75 treated patients (213 trials), somnolence decreased using stimulants (mainly amphetamines) in 40% of cases, while neuroleptics and antidepressants were of poor benefit. Only lithium (but not carbamazepine or other antiepileptics) had a higher reported response rate (41%) for stopping relapses when compared to medical abstention (19%). Secondary KLS (n = 18) patients were older and had more frequent and longer episodes, but had clinical symptoms and treatment responses similar to primary cases. In conclusion, KLS is a unique disease which may be more severe in female and secondary cases.

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