Kleine Levin Syndrome
A. The patient experiences recurrent episodes of excessive sleep (>11 hours/day).
B. Episodes occur at least once a year, and are generally 2 days to 4 weeks in duration.
C. During episodes, when awake, cognition is abnormal with feeling of unreality or confusion. Behavioral abnormalities such as megaphagia or hypersexuality may occur in some episodes.
D. The patient has normal alertness, cognitive functioning, and behavior between the episodes.
E. The condition is not better accounted for by another mental disorder (e.g, mood disturbance), and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or another general medical condition (e.g. a metabolic disorder).
There is increasing evidence that the disorder is a genuine disease entity based on its consistent description in term of clinical presentation, demographics (70% male, adolescent), evolution (eventually disappears), and therapeutic response (almost nothing is effective). It may be misdiagnosed as depression or other psychiatric consequences, with devastating consequences.
Relationship to International Classification of Diseases-10
Other Sleep Disorders: Kleine-Levin Syndrome G47.8
Relationship to International Classification of Sleep Disorders 2nd Edition
Recurrent Hypersomnia 327.13
References
1. Arnulf I, Lin L, Gadoth N, File J, Lecendreux M, Franco P, Zeitzer J, Lo B, Faraco JH, Mignot E: Kleine-Levin syndrome: a systematic study of 108 patients. Ann Neurol 2008; 63(4):482-93
2. Arnulf I, Zeitzer JM, File J, Farber N, Mignot E: Kleine-Levin syndrome: a systematic review of 186 cases in the literature. Brain 2005; 128(Pt 12):2763-76