Recurrent hypersomnia: Report of medication-responsive cases

Perin, Bruna Valentina; Rodrigues, Iorrana; Giasson, Franciele T.B.; Balen, Matheus; Posenato, Naiana; Forcelini, Cassiano Mateus

doi:10.1016/j.slsci.2015.06.003

Cited by 2 publications

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“…Dopamine agonists, if used early [ 4 , 8 , 10 ], and gabapentin [ 89 ] may both be effective. Carbamazepine [ 90 , 91 ], lamotrigine [ 92 ], valproate [ 4 , 93 , 94 ], and lithium [ 4 , 95 – 99 ] have all been reported to be beneficial, and interestingly these medications are also reported to have anti-inflammatory properties [ 100 – 104 ]. Perhaps surprisingly given the putative autoimmune aetiology, steroids have infrequently been used, with a recent case report of an influenza A-triggered case of KLS being treated with dexamethasone on initial presentation with uncertain benefit [ 48 ].…”

Section: Introductionmentioning

confidence: 99%

Kleine-Levin syndrome: clues to aetiology

2018

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Kleine-Levin syndrome (KLS) is the commonest recurrent sleep disorder, with a prevalence of 1–2 per million population. Clear diagnostic criteria are now defined, but effective treatment remains elusive. The significant body of published literature allows consideration of possible aetiological mechanisms, an understanding of which could guide the development of therapeutic strategies. Functional imaging studies have been inconclusive; although diencephalic abnormalities are a common finding, no consistent pattern has emerged, and these studies have not revealed the mechanism(s) underlying the development of the abnormalities detected. An autoimmune aetiology is consistent with the available data. In this review, we argue that, in order to further our understanding of KLS, there needs to be a co-ordinated international effort to standardise approaches to functional imaging studies, genetic analyses that specifically address the possibility of an autoimmune aetiology, and clinical trials of immunosuppressive therapies.

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Section: Introductionmentioning

confidence: 99%

Kleine-Levin syndrome: clues to aetiology

2018

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Kleine-Levin Syndrome

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Guilleminault

2016

Curr Treat Options Neurol

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Kleine-Levin Syndrome [KLS] is often under-recognized and also misdiagnosed. When suspicion for KLS is raised, a thorough clinical evaluation should be performed, including detailed history from family members and a neurologic and psychiatric examination. Additional studies may include PSG, EEG, neuroimaging, as well as serological and CSF studies to rule out alternative diagnoses as clinically indicated. After arriving at a diagnosis of KLS, the foundation of care is supportive. Patients and their families should be provided with education about the disease. During symptomatic periods, patients should be allowed to rest at home under caregiver supervision. Caregivers should pay special attention to the patient's eating habits and mood. Patients should not be allowed to drive or operate heavy machinery during these episodes. In between episodes, avoidance of reported triggers, such as alcohol and infection are encouraged as is maintenance of a regular sleep-wake cycle. Pharmacologic therapy has not been well-studied and for most patients is not necessary. For more severe cases, targeted symptomatic therapy, such as modafinil or amantadine for somnolence or risperidone for psychosis may be considered depending on the patient's symptomatology. Lithium has the best data to support its use as a prophylactic agent and for patients with severe or frequent episodes, may be considered.

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Recurrent hypersomnia: Report of medication-responsive cases

Cited by 2 publications

References 18 publications

Kleine-Levin syndrome: clues to aetiology

Kleine-Levin syndrome: clues to aetiology

Kleine-Levin Syndrome

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