KLEINE-LEVIN SYNDROME IN A MALE PATIENT. A CLINICAL CASE REPORT

Abstract

DOI: https://doi.org/10.46296/yc.v10i18.0865

Abstract

Introduction: Kleine-Levin syndrome is a rare, recurrent hypersomnia characterized by reversible episodes of extreme sleepiness, cognitive impairment, and behavioral changes, with almost complete interepisode recovery. Its low prevalence and overlap with neurological, psychiatric, metabolic, and toxic disorders contribute to diagnostic delays. Case report: A 16-year-old male high school student with no relevant neurological or psychiatric history presented with three self-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.