THE KLEINE-LEVIN-SYNDROME - DIAGNOSTIC AN D THERAPEUTIC PROBLEMS

An overview of the literature is given and an attempt is made to descr ibe the diagnostic problems associated with this etiologically unclear disorder. The only successful therapy to date is treatment with lithi um. A case study is presented of a 14-year-old boy with typical sympto ms. Within a period of 12 months the boy had 6 episodes characterized by hypersomnia and hyperphagia, each lasting between 8 and 14 days. Th e symptom-free intervals lasted from 10 days to 8 months. Extensive me dical and neurological evaluation including single-photon emission-com puted tomography (SPECT) showed no abnormalities, and no criteria for another psychiatric disorder were met. After the sixth episode we cons idered treating the patient with lithium, but this option was rejected by his family. The patient has remained asymptomatic (36-month follow -up). A possible relationship to endogenous psychotic disorders and th e role of neurotransmitter metabolism are discussed. Computer-assisted analysis of electroencephalographic activity revealed high signal com plexity, which we believe suggests a primary cortical regulatory defec t.