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The Kleine-Levin syndrome (Sleeping Beauty )

Overview:
The Kleine-Levin syndrome is an extremely rare medical condition, known as the Sleeping Beauty syndrome, in which the patient suffers from episodes of
hypersomnia so it is considered a rare sleep disorder. This syndrome was named after the two people who made the discovery, meaning Will Kleine and Max Levin.  The person with this syndrome can sleep more than 20 hours per day   .
Symptoms:
The most common symptoms include:
-Hypersomnia (prolonged sleep)
-Excessive tiredness (episodic)
-Active episode – sleep duration varies between 15 and 21 hours per day
-Excessive appetite – can be accompanied by cravings that unusual, affecting a large percent of the patients
-Frequent sexual urges (hypersexuality – especially in males)
-Mood swings
-Changes in the cognitive function
-Hallucinations and delusions
-Depression and anxiety (not in all patients)
-No recollection of what happened during the episode
-Repetitive behavior
-Headaches
-Improper behavior during the episodes (childlike)
-During the episode, the communication abilities, as well as the coordination might be impaired
-Malfunctioning of the autonomic nervous system
-The first episode is accompanied by flu-like symptoms (viral infection)
Causes:
The main cause for this syndrome has not identified yet but other causes involve :
- Hypothalamic or circadian dysfunction
- Dysfunction of the temporal lobe (especially in the patients who present cognitive impairment)
- Frontal lobe dysfunction (in patients who present severe apathy)
- Problems related to the brain neurotransmitters (dopamine, serotonin) – imbalance in the pathways through which these substances are transmitted
- Viral infections – most commonly with: adenovirus, influenza A virus, herpes zoster, varicella zoster and Epstein-Barr
- Genetics or environment (the condition has been diagnosed in members belonging to the same family)
Factors increase the risk of Kleine-Levin Syndrome include :
1-Alcohol consumption  
2-Head injury
3-International travel
4-Sleep
Diagnosis
The most common diagnoses of the Kleine-Levin syndrome involve:
Diagnosis of exclusion – the patient is tested for other conditions and the diagnosis is confirmed only after excluding other potential causes
MRI – can be useful in determining whether the patient is suffering from stroke, multiple sclerosis or brain tumors
Toxicology testing – exclusion of substance abuse diagnosis
Lumbar puncture – exclusion of encephalitis diagnosis
Electroencephalography (EEG) – exclusion of temporal epilepticus diagnosis
Other tests:
-Sleep studies
-SPECT (Single-photon emission computer tomography)
-Serum biology
-C-Reactive protein
-Lectins
Treatment:
The treatment involves:
1-Stimulants – modafinil (reduce the hypersomnia but can lead to behavioral problems)
2-Lithium – reduce the length, intensity and frequency of the episodes (may have side-effects, affecting the kidneys or the thyroid gland)
3-Antipsychotics and benzodiazepines – these are useful in alleviating the symptoms that may appear due to the psychosis or anxiety
4-Carbamazepine – not effective in all patients
5-Sleep hygiene


The Kleine-Levin syndrome (Sleeping Beauty ) Reviewed by Tpdsm on August 30, 2017 Rating: 5

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