The Kleine-Levin syndrome

Abstract

Why write an editorial on a rare and enigmatic disorder, which is difficult to diagnose, lacks a definite laboratory test and is hardly mentioned in the classical text books i.e., 18 sentences in Bradley’s Neurology in Clinical Practice [1], and 15 words including the two stating the name of the syndrome in Menkes Textbook of Child Neurology [2]. The average practicing pediatric neurologist is entitled to meet at least once, an adolescent with a history of episodic hypersomnia. He will most probably consider a number of possibilities in the differential diagnosis which are nicely outlined in the review on The KleineLevin syndrome (KLS) in this issue [3], and might also raise the possibility of KLS. However, when such a youngster presents for the first time, the diagnostic dilemma is much more difficult. In the majority of cases studies such as lumbar puncture, electroencephalography, brain imaging and urinary toxicology screen will be performed, a psychiatry consult will be obtained and the boy or girl will be admitted to the hospital. In many, a provisional diagnosis of “flu” or “encephalitis” will be reached and in some with non-specific electroencephalographic changes the diagnosis of epilepsy will be offered followed by recommendation for long-term anticonvulsant therapy, especially on a repeated event. We have been encountered with patients in whom drug abuse was suspected with consequent legal implications. Rarely the hypersexual behavior may be inter-