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.
Keywords
Kleine-Levin syndrome - child - sleep - hypersomnia
