Kleine–Levin syndrome in a 14-year-old girl: CSF hypocretin-1 measurements

Preliminary results on CSF biomarkers for hypothalamic dysfunction in Kleine–Levin syndrome

“…CSF hypocretin-1 might be temporarily decreased during KLS hypersomnia episodes, in line with findings [5][6][7]. CSF HA and t-MHA measurements in and out of episode revealed a two-fold inepisode decrease in HA in the more severe patient, with no significant change for the second patient, nor for t-MHA levels.…”

“…Hypocretin and histamine neurons in the lateral and posterior hypothalamus play critical roles in wakefulness maintenance, feeding behavior, and neuroendocrine and autonomic function [4]. A few CSF hypocretin-1 measurements in and out of KLS episodes have been reported in the literature [5][6][7]. We report on measurements of three CSF hypothalamic biomarkers: hypocretin-1, histamine (HA), and its major metabolite tele-methylhistamine (t-MHA) in two patients with typical KLS during symptomatic and asymptomatic periods.…”

Cerebrospinal fluid hypocretin-1 levels during the active period of cluster headache

“…Moreover, our preliminary study, although the sample was relatively small, found a relatively low hypocretin-1 concentration during the active period of episodic CH in one patient. A two-fold decrease in hypocretin-1 levels between the asymptomatic interval and the symptomatic period was previously detected in Kleine-Levin syndrome, despite the fact that the lower hypocretin-1 concentration was still within the normal range (11). Given that CH, like Kleine-Levin syndrome, is an episodic brain disorder, additional measurements of hypocretin-1 in both a symptomatic period and an asymptomatic interval are warranted.…”

First Attack of Kleine-Levin Syndrome Triggered by Influenza B Mimicking Influenza-associated Encephalopathy

“…Hypocretin levels were normal during asymptomatic intervals in patients with KLS (16) and during symptomatic periods in some patients (17). However, hypocretin levels during symptomatic periods in 2 patients with KLS were relatively low compared to the levels during the asymptomatic period, which were within normal or intermediate levels (18,19). We measured hypocretin levels during the first attack of KLS, which occurred just after the influenza B infection, and the levels were intermediate.…”