Kleine-Levin syndrome: symptoms, causes and treatment

Sleep hours and hours without interruption; For many people it may seem like a pleasure to be able to establish a prolonged rest period in which to replenish energy after a hard day's work.

But for others, it can be a real ordeal that greatly limits their lives because they can spend most of of the day sleeping, in addition to presenting serious alterations in behavior and mood during the time they remain awake. We are talking about those people who suffer from the disorder known as Kleine-Levin syndrome, a disorder related to hypersomnia.

sleeping beauty syndrome

Also known as sleeping beauty syndrome, Kleine Levin syndrome is a disorder of neurological origin that is characterized by the presence of episodes of profound hypersomnia, in which the individual can sleep up to twenty hours straight.

In addition to hypersomnia, characteristic of this syndrome is the presence of cognitive and behavioral disturbances. Memory and the ability to reason and judgment may also be altered, as well as physical and mental slowdown and fatigue.

During the awake period, the individual with Kleine-Levin syndrome manifests uninhibited and even compulsive behavior, with hyperphagia and hypersexuality and an attitude between childish and aggressive. The subject has a labile emotionality and irritable that can trigger violent actions. Sometimes the presence of dissociative phenomena such as derealization, or perceptual disturbances such as hallucinations.

This disorder often begins in adolescence., with a higher prevalence in males, which causes them a severe disability in the periods of time in which they present the symptoms.

Episodes can last days or weeks, and can occur numerous times throughout the year. However, in the period of time between the different episodes, the behavior and the amount of sleep is normative, recovering their normal mental functions and being able to carry out a normal life in those moments.

an unknown cause

The causes of this neurological disorder are not yet known., although there is speculation about the presence of alterations in the functioning of the hypothalamus and the whole of the limbic system and some others subcortical structures linked to the regulation of emotions and sleep.

Specifically, it has been observed that hypoperfusion occurs in the limbic system in many patients, thalamus and frontotemporal cortex (that is, the amount of blood that reaches these regions is reduced, so they are not as irrigated as they should). Also electroencephalic activity seems to slow down.

A possible genetic influence that could explain the phenomenon has been studied, but although it has been found that sometimes there are several cases in the same family, there is no evidence to support it. confirm. It has also been speculated that it may be due to head trauma, infectious medical diseases, or severe stress.

Treatment of Kleine-Levin syndrome

Kleine-Levin syndrome does not have a clear etiology, so it is difficult to carry out a curative treatment. The treatment that is applied in the presence of this disorder usually focuses on the symptoms.

As with other hypersomnias, various psychiatric drugs to control symptoms. The use of stimulants can favor an increase in the activity of the subjects and reduce the episodes of sleep in duration and frequency, although on the other hand it can harm the presence of impulsive actions and hallucinations. Also they antipsychotics have been used to manage behavioral disturbances, as well as antidepressants such as MAOIs and imapramine, mood stabilizers and anticonvulsants.

psychological intervention

At a psychological level it is necessary use psychoeducation both with the patient and with the environment due to the complications that his condition can entail at an affective, behavioral and social level, which can damage the support and help networks available to patients affected by this disorder. Emotional problems derived from experiencing the disorder should also be treated, especially in asymptomatic periods.

The use of cognitive-behavioral techniques It is another element to take into account in this aspect, making use of cognitive restructuring or learning ways to manage the situation. The aim is to make the interpretation of the experience of the symptoms as accurate as possible.

Fortunately, in many cases, despite being recurrent Kleine-Levin syndrome tends to disappear over the years.

• You may be interested in: "The 10 most used cognitive-behavioral techniques"

Bibliographic references:

• Arias, M.; Crespo, J.M.; Perez, J: Requena, I.; Seser, A. & Peletiero, M. (2002). Kleine-Levin syndrome: diagnostic contribution of brain SPECT. Rev. Neurol.; 35 (6): 531-533.

• Arnulf, A.; Lecendreux, M.; Franco, P. & Dauvilliers, Y. (2008). Kleine-Levine syndrome. Encyclopédie Orphanet. [Online]. Available at: www.orpha.net/data/patho/Pro/fr/KleineLevin-FRfrPro10326v01.pdf [20/05/2017].

• Erro, M.E. and Zandio, B. (2007). Hypersomnias: diagnosis, classification and treatment. Annals of the Health System of Navarre; 30. Hospital of Navarre. Pamplona.