A rare form of
periodic hypersomnia associated with hyperphagia occurring in males
between 10 to 25 years old. Characterized by periods of ravenous appetite
alternating with prolonged sleep, as long as 18 hours, along with
behavioral disturbances, impaired thought processes, and hallucinations.
Acute illness or fatigue may precede an episode which may occur as
often as several times a year.
Between attacks
the person recovers completely and the sleep periods usually disappear
in adult age. This syndrome may easily be confused for other neurological,
metabolical or psychiatric disease.
Also known as Critchley's Syndrome, Kleine-Levin-Critchley Syndrome,
Kleine-Levin Hibernation Syndrome, Familial Hibernation Syndrome,
Periodic Somnolence and Morbid Hunger. The main symptoms are:
The disorder primarily affects adolescent males aged 15 - 25 years.
When awake, affected individuals may exhibit irritability, lack of
energy (lethargy), and/or lack of emotions (apathy).
They may also appear confused (disoriented) and experience hallucinations
When present, symptoms may persist for days to weeks.
Symptoms cyclical.
Hypersomnia.
Hypersexual behavior.
Excessive eating.
Confusion.
Irritability.
Restlessness.
Euphoria.
Hallucinations.
Delusions.
Schizophreniform states
Differential Diagnosis:
Some disorders
display similar or sometimes even the same symptom. The clinician,
therefore, in his diagnostic attempt, has to differentiate against
the following disorders which one needs to be ruled out to establish
a precise diagnosis.
Mood
Disorders.
Sleepiness during the premenstrual period in teenaged girls.
Onset is typically
around adolescence to the late teens. The disorder is 4 times more
common in males than in females. Symptoms may be related to malfunction
of the hypothalamus, the part of the brain that governs appetite and
sleep. In most cases, the symptoms eventually disappear with advancing
age.
Treatment:
There is no definitive
treatment for Kleine-Levin Syndrome.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Stimulants:
Amphetamines.
Methylphenidate.
Modafinil.
Lithium.
Carbamazepine.
Responses to treatment have often been limited.
