Kleine-Levin syndrome: interface between neurology and psychiatry

We report the first episode of Kleine-Levin (KLS) syndrome in a 17-year-old male. The illness onset, clinical features, neuropsychological evaluation and polysomnographic recording are described. Typical symptoms hypersomnia, hyperphagia and sexual disinhibition were observed besides behavioral disturbances, polysonographic and neuropsychological alterations. Behavioral disturbances similar to a manic episode including psychotic symptoms were relevant. The pharmacologic treatment included lithium, methylphenidate and risperidone. The introduction of risperidone aimed the control of psychotic symptoms and the persistent manifestations of hypersexuality after sleepness control and to the best of our knowledge there are no other report regarding risperidone use for KLS in the literature.

Relatamos o primeiro episódio de síndrome de Kleine-Levin (SKL) num adolescente de 17 anos. São descritos o modo de aparecimento da doença, achados clínicos, avaliação neuropsicológica e polissonografia. Foram observados sintomas típicos como hipersonolência, hiperfagia e desinibição sexual, e outras alterações comportamentais, polissonográficas e neuropsicológicas. As alterações comportamentais assemelhadas a um episódio de mania, incluindo sintomas psicóticos, foram relevantes. O tratamento farmacológico incluiu lítio, metilfenidato e risperidona. A introdução de risperidona teve por objetivo o controle dos sintomas psicóticos e das persistentes manifestações da hipersexualidade, que permaneceram após diminuição da sonolência; não temos conhecimento de relatos anteriores, na literatura, de seu uso no tratamento da SKL.

Kleine-Levin syndrome: clinical course, polysomnography and multiple sleep latency test: case report

A case of Kleine-Levin syndrome, with chronic severe periodic hypersomnia is described in a 17-year-old female. The first episode started when she was 15 years old. The episodes were characterized by periodic hypersomnia accompanied by hyperphagia, lasting 5 days, and repeating at 28 to 60 day intervals. The severity of hypersomnia prevented her from attending school activities. Outside the hypersomnia periods, she was asymptomatic. EEG, brain computerized tomography and brain nuclear magnetic resonance were normal; all-night polysomnography, Multiple Sleep Latency Test (MSLT) and Epworth Sleepiness Scale (ESS) were within normal limits. During the period of hypersomnolence, polysomnography showed short sleep latency and short REM latency. MSLT mean sleep latency was 1.8 min; and REM period was present in one subtest; the ESS was markedly elevated.

Síndrome de Kleine-Levin associada a presença de anticorpos antifosfolipídios / Kleine-Levin synsdrome associated to antiphospholipid antibodies

Descriçäo de um caso de síndrome de Kleine-Levin, manifestado por hipersonia predominante, em um adolescente de 13 anos, acompanhado ambulatorialmente há vários anos por apresentar fenômeno de Raynaud, presença de anticorpos antifosfolipídios e FAN positivo. O caso ilustra a discussäo de uma doença bastante rara, com ênfase nos aspectos importantes de epidemiologia, diagnóstico e terapêutica

Kleine-levin syndrome case report

A case of Kleine- Levin syndrome is reported in a 28-year-old man, which started at the age of 19 years, with typical features of the syndrome, i.e., excessive sleepiness for 1-2 weeks, hyperphagia and irritability which recurred about twice annually. The patient was treated with Lithium which apparently had beneficial effects on the course of the illness