A variant of the Kleine-Levin syndrome precipitated by both Epstein-Barr and Varicella-Zoster virus infections

Abstract

The Kleine-Levin Syndrome (KLS) was described by Kleine ~1925) then Levin (1936), but Critchley's monograph of 1962 provides the classic description. He described I1 adolescent boys with episodic hypersomnia and inordinate hunger (megaphagia) while awake. Diffuse cognitive impairment, perplexity, varying degrees of mood disturbance, aad disinhibited behavior followed an invariably self-limiting course. Frequency and severity of episodes decreased with age and recovery was ultimately complete (,~lit,.h,~y 1962). Head trauma (Will et al 1988) and encephalitis (Merriam 1986) have been reported as antecedents of KLS, although most cases lack precipitants. Disturbed sleep and eating suggest hypothalamic pathology and postmortem reports support this idea (Takrani and Cronin 1986; Carpenter et al 1982. Since Critchley's original description of adolescent males, cases have been reported without megaphagia, abnormal mood, or behaviorial disturbance (Ogura e: al 1976; Abe 1977) and in women (Takrani and Cronin 1986). ~¢e describe here an atypical case in which megaphagia was consistently absent. Each episode was preceded by a viral infection.