Klein-Levin Syndrome: Causes, Symptoms and Treatment

Klein-Levin syndrome is a periodic spontaneously arising disorder of sleep and wakefulness in the form of rather large intervals of sleep. Sleep can last several days or even weeks. A sick person wakes up for a short time, but does not behave adequately, consumes all sorts of food around him. Periods such a "hibernation" are then amnesed by the sick. In the inter-attack period, the person is absolutely healthy. The Klein-Levin syndrome is a very rare pathology, but its unusual symptomatology attracts the attention of researchers. Let us also know what pathology this is, why it arises, what is characterized and how it is treated. This article is about this.

General information about the disease

The first mention of the syndrome dates back to 1925. German psychiatrist Willie Klein described several cases (9) of "hibernation" among his patients. In 1936, American neurologist Max Levin described his five observations of a combination of wakefulness and eating disorders. Therefore, the syndrome has such a double name. Synonyms of Klein-Levin syndrome are the syndrome of hypersomnia and hyperphagia (bulimia), periodic hypersomnia, syndrome Sleeping Beauty (because they assume that the main character of the fairy tale of the same name had a real prototype in life).

To date, despite its rarity, the syndrome is isolated as a separate disease among other sleep disorders. This disease affects mainly males in adolescence and sometimes men over 20 years of age. Several cases of Klein-Levin syndrome in girls of pubertal period are described, which, according to scientists, is associated with fluctuations in the content of progesterone at this age.

Causes

The exact causes and mechanisms of the development of the disease are still unknown. A number of assumptions have been confirmed by modern research methods (positron emission tomography).

The main culprits in the development of Klein-Levin syndrome are dysfunctions in the reticular formation of the brain and the hypothalamus, the limbic system. Hormonal alteration of the body is almost an obligatory prerequisite for the onset of the disease. This is confirmed by the primary identification of the syndrome in adolescents of both sexes. In addition, it is assumed a certain role of viruses, craniocerebral trauma, an increase in body temperature of an unclear genesis in the development of symptoms. In some cases, hereditary nature is traced, as several members of the same family suffer from such a rare disease.

It is difficult to say which of the above factors is the main one. Most scientists agree that at the heart of the disease is some genetic defect in the regulation of activity hypothalamus and limbic system of the brain, which is realized with a hormonal outbreak of the pubertal period.

Symptoms

Patients sleep most of the day, wake up only to eat or go to the toilet.

The main symptoms of Klein-Levin syndrome are as follows:

• bouts of prolonged sleep for 18-20 hours, which are interrupted only to meet natural needs (go to the toilet and eat). It is simply impossible to wake a patient in this interval;
• similar seizures last for several days, and sometimes even weeks (the maximum period of "hibernation" is described - about 6 weeks);
• sleep during seizures is not quite full, that is, it does not give a sense of satisfaction and rest. Therefore, waking up for a short period of time, the patient again falls asleep. When the episode ends finally, a person feels himself asleep, but hungry;
• in those moments when the patient wakes up, he is tormented by a "wild" famine. A person eats everything that he sees and finds, indiscriminately, without special consideration for the taste compatibility of the products (that is, it can at the same time eat salted fish at the same time and eat it with a cake). Although some cravings for sweets can still be traced. Having satisfied the feeling of hunger, a person goes to sleep again;
• small intervals of wakefulness can be accompanied by mental changes: aggressiveness, excessive irritability, emotionality, psychomotor agitation, hallucinations, euphoria, schizophreniform states, hypersexuality (which is manifested by masturbation). These same symptoms can occur a few hours before the "first" fall asleep when the disease worsens;
• vegetative components of seizures: excessive sweating, cyanotic brushes and feet, lips, nasolabial triangle;
• changes in blood glucose levels during seizures;
• amnesia of seizures. When the exacerbation ends and the person returns to normal, he usually does not remember these few days or even weeks at all, suggesting that he slept only one night;
• absence of any deviations in the inter-attack period, that is, no changes can not be identified. Man turns out to be perfectly healthy. The only thing that, due to uncontrolled appetite during the episodes of "hibernation", it is possible to increase the body weight.

On average, after the end of one episode of "hibernation" about 6 months there is a remission, and then the attack repeats. But this fact is not a dogma, gaps can be different.

The Klein-Levin syndrome, having emerged unexpectedly and existed for a time (maybe several years), is gradually coming to naught. What does this mean? Attacks become less prolonged, the gaps between them increase. In the end, the disease disappears by itself, leaving no trace (well, perhaps, in addition to the extra kilograms that have been eaten during this time, although this is not necessarily necessary). In the medical literature there is information about the 18-year experience of the disease.

Treatment

There is no clear scheme for treating Klein-Levin syndrome. First, the exact cause of the disease is not established, and secondly, the disease spontaneously regresses, leaving no trace behind. Therefore, some scientists do not see the advisability of drug treatment.

And yet in cases where a person "hibernates" for several weeks, and even with uncontrollable gluttony and mental disorders that cause discomfort to relatives, use a number of drugs. There is no reliable evidence of effectiveness of either of them, because doctors have tried to cure too few cases with their help. However, given that the drugs lead to a reduction in the duration of seizures, prolonged remission, smooth out the symptoms during episodes of "hibernation", their use can be considered justified. To this end, use:

• antidepressants;
• tranquilizers;
• antipsychotics;
• lithium preparations.

All these drugs are purely symptomatic in this case. They help, perhaps, not so much the patient as his relatives survive such a painful period. A native patient should remember that the Klein-Levin syndrome will inevitably result in an independent recovery, and have patience.

So, the Klein-Levin syndrome is a mysterious reality from a fairy tale about Sleeping Beauty. Only here the heroes in life become more of a male person and they recover not from a kiss. The exact causes of the disease are still unknown. Attacks of prolonged sleep with a break for a monstrous appetite in combination with mental disorders constitute the main group of symptoms of this disease. Effective methods of treatment does not exist. The period of episodes with "hibernation" should be simply experienced, as the disease ends in a spontaneous recovery. Radical cure for Klein-Levin syndrome is the task of the future.

"Sleeping Beauty" from England sleeps for 22 hours a day:

"Sleeping Beauty" from England sleeps for 22 hours a day

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