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.
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.
