The Kleine-Levin syndrome as a neuropsychiatric disorder: A case report

The Kleine-Levin syndrome (KLS) is characterized by periodic, sudden-onset episodes of hypersomnia, compulsive hyperphagia, and behavioral-emotional d isorders (typically indiscriminate hypersexuality, irritability, impulsive behaviors), lasting from a few days to a few weeks, with almost complete re mission in the intercritical periods. Depression, confusion, and thought di sorders are frequently associated with the critical symptomatology, and the y may suggest other psychiatric diagnoses (schizophrenia, mood disorder, co nversion disorder) or a substance abuse. A diencephalic-hypothalamic dysfun ction is suspected, even if this composite symptomatology cannot easily be linked to a simple mechanism. The aim of this article is to illustrate prob lems in differential diagnosis, using a case approach. History, course, and therapeutic intervention in a 21-year-old patient with KLS, associated wit h a clear psychiatric symptomatology and a critical affective pattern, is r eported. Psychiatric correlates of KLS are discussed, including the relatio nship with affective disorders and the possible emotional impact of the att acks. Implications regarding a combined psychological and pharmacological t reatment are also discussed.