Affiliations: Department of Pediatrics, Taif Children's
Hospital, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia | Department of Pediatrics, Faculty of Medicine,
King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
Note: [] Correspondence: Dr. Mohammed M.S. Jan, Professor and Consultant
of Pediatric Neurology, Department of Pediatric, Faculty of Medicine, King
AbdulAziz University, P.O. Box 80215, Jeddah 21589, Kingdom of Saudi Arabia.
Tel.: +99626401000 (ext. 20208); Fax: +99626403975; E-mail: mmjan@kau.edu.sa
Abstract: Kleine-Levin syndrome~is an exceptionally rare disorder
characterized by recurrent episodes of hypersomnia associated with varying
degrees of behavioral or cognitive disturbances and compulsive eating behavior.
The disorder occurs predominantly in adolescent males with a benign clinical
course and spontaneous remission as long as other neurological or psychiatric
diseases are excluded. A viral or an autoimmune etiology has been suggested as
up to 70% of patients have flu-like symptoms at the onset of their symptoms.
In this report, we present a 9-year-old female patient with this rare disorder
and review the relevant pediatric literature. She was previously healthy and
presented with a 1-month history of generalized fatigue, excessive sleep and
behavioral change. She would sleep for most of the day even while sitting and
would resist being awakened. During brief periods of wakefulness, her mood will
fluctuate from apathy to anger, sadness and aggression for minimal reasons. She
would eat and drink excessively with a notable weight gain. Clinical
examination and detailed investigations, including brain computerized
tomography scan and electroencephalography were within normal limits.
Remarkable improvement of her symptoms was noted after initiating
methylphenidate and carbamazepine. We conclude that Kleine-Levin syndrome is an
interesting rare disorder that needs to be diagnosed after excluding other
causes of excessive sleep. Early recognition would result in appropriate
treatment and shortened period of hospitalization.
