Ochoa-Semería et al. (2026)
limited episodes of hypersomnia lasting 8 to 12 days over a six-month period. During these
episodes, he slept between 18 and 22 hours per day and exhibited psychomotor retardation,
derealization, irritability, hyperphagia, and decreased school performance, without fever,
seizures, substance use, or focal neurological deficits. Between episodes, he recovered his usual
sleep pattern, behavior, and functional performance. The evaluation included a complete blood
count, metabolic profile, thyroid function tests, inflammatory markers, serologies, urine toxicology
screen, electroencephalogram, brain MRI, polysomnography, and psychiatric evaluation, with no
findings to explain the clinical presentation. Based on the episodic recurrence, normal intercritical
periods, and reasonable exclusion of alternative diagnoses, a clinical diagnosis of Kleine-Levin
syndrome was established. Family education, sleep hygiene instruction, a safety plan during
episodes, and multidisciplinary follow-up were prescribed. Due to functionally disabling
recurrence, lithium carbonate prophylaxis was initiated, with monitoring of renal and thyroid
function, as well as serum levels. No new episodes were recorded during four months of follow-
up. Conclusion: This case illustrates the need to recognize the episodic clinical pattern of Kleine-
Levin syndrome and to systematically rule out secondary causes of recurrent hypersomnia. The
approach should prioritize safety, family education, academic support, and neurological and
psychiatric follow-up.
Keywords: Kleine-Levin syndrome; recurrent hypersomnia; sleep disorders; adolescent; case
report.
1
. Introducción
Aunque puede presentarse en
distintas edades, el SKL afecta con
mayor frecuencia a adolescentes y
adultos jóvenes, con predominio
El síndrome de Kleine-Levin (SKL)
es un trastorno raro del sueño
incluido dentro de las hipersomnias
recurrentes. Se caracteriza por
descrito
en
varones.(2,3)
La
fisiopatología continúa sin estar
completamente aclarada; se han
propuesto mecanismos relacionados
episodios
de
hipersomnolencia
intensa que aparecen de forma
abrupta, duran días o semanas y se
acompañan, en grado variable, de
con genética,
disfunción hipotalámica, alteraciones
inmunoinflamatorias factores
vulnerabilidad
alteración
cognitiva,
apatía,
cambios
y
perceptivos,
desinhibición
hiperfagia,
desencadenantes como infecciones
respiratorias, privación de sueño,
estrés, traumatismos menores o
consumo de alcohol.(2-5)
conductual
o
manifestaciones afectivas. Entre los
episodios, el paciente suele
recuperar su estado basal, lo que
constituye un elemento clínico
esencial para diferenciarlo de otras
causas persistentes de somnolencia
diurna excesiva.(1,2)
El diagnóstico es fundamentalmente
clínico y de exclusión. No existe un
biomarcador específico, por lo que la
evaluación debe descartar epilepsia,
encefalitis, lesiones estructurales del