Kleine-Levin syndrome: an atypical case?

Abstract

A case of Kleine-Levin Syndrome is reported. While no significant physiological abnormalities were found, the patient's mental status when he was awakened during the episode studied bore the hallmarks of an acute organic brain syndrome. There were also signs suggestive of a flight into sleep, a form of emergency response consistent with his defensive repertoire as revealed in extensive psychiatric and psychological examinations. Presenting a sharp contrast to the impressions of almost all previous observers, this patient appeared to be quite seriously chronically ill. In sum, the history of this case suggests that a rich mixture of psychological and physiological stressors precipitated an attack of hypersomnia, megaphagia, activated sexuality and an altered state of consciousness with both organic properties and a strong flavor of secondary gain in a “borderline” young man. It is hoped that it will be possible to study future patients with this disorder more thoroughly in prolonged intensive psychotherapy, with specialized psychological testing during and between episodes and with the help of advanced sleep research techniques.