Background:The combination of hypersomnia and any of: hyper-phagia, hyper-sexuality, or mood changes is known as Klein-Levin Syndrome. This syndrome is quite infrequent and mostly restricted to adolescent males.Case Description: A young patient with KLS is presented in this report. He was presented with relapsing-remitting hypersomnia and irritability more than two years after incurring a traumatic brain injury. Magnetic resonance imaging (MRI) showed hyperintensity in the posterolateral part of the right temporal region, matched with the brain injuries caused by the old trauma.His extremely long sleep episodes forced medical team to provide him with some necessary basic cares such as nasogastric tube and urinary catheter.Five consecutive weeks of taking modafinil got his sleep pattern back to normal. Conclusion:In addition to medical treatment which is inevitable for severe cases, family and social support is extremely vital for managing KLS patients.
Background: Major depressive disorder is one of the most common psychiatric illnesses. It is counted as an important suicide-attempting factor. Beside common and known suicide methods such as pesticide poisoning and hanging, some unusual methods (adapted by major depressive disorder patients) are reported in the literature. One of these methods is intracranial swing needle insertion. Case presentation: Hereby, we detail a 44-year-old woman who was admitted to our hospital due to a sewing needle in her brain tissue. The first sign suggesting the existence of a metal foreign body in her brain was the rejection of magnetic resonance imaging ordered (follow-up of a previous admission). Later, a sewing needle was observed in her skull inserted in a suicidal attempt. Her denial of the attempt has aroused the medical team attention to make further study of the patient from a psychiatric point of view. The psychiatric study expressed major depressive disorder in the patient which can justify her suicide intention in the needle insertion. Conclusions: Treating such patients should be tackled in two fronts. From neurosurgical point of view, it should be decided whether to extract the foreign body or conduct a follow-up in order to determine the necessary time for operation. On the other hand, from a psychiatric point of view, rigorous consult sessions with patient and family members are required to prevent recurrence of such attempts.
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