We found a rare case of Kleine-Levin syndrome in an adolescent female with decreased intracranial pressure. The patient developed symptoms of decreased appetite, depression and anhedonia. The clinical symptoms were similar to an affective disorder of depression attack since the patient had periodic symptoms of excessive sleep and gluttony, accompanied by an involuntary special "Crouching phenomenon" involving hip and knee flexion while holding her legs tightly and lying on her knees. She was not considered narcoleptic after polysomnography and multiple sleep latency tests. Finally, a lumbar puncture revealed low intracranial pressure (65mm H2O). Hypotha- lamic orexin-A detected in the cerebrospinal fluid was at the lower normal limit. After symptomatic treatment involving fluid infusion and increasing intracranial perfusion pressure, the patient's periodic symptoms and social functioning improved with reduced instances of the special "Crouching phenomenon."
A 41-year-old female patient presented initially with right limb ataxia, which resembled the clinical process of acute cerebrovascular disease. However, no obvious acute infarction was found on Cranial MR2. The patient's symptoms did not significantly improve after treatment with antiplatelet aggregation, stabilizing plate, clearing oxygen free radicals, and improving circulation. The patient was later diagnosed with subacute cerebellar degeneration by detecting Paratumor-related antibodies in cerebrospinal fluid and blood. Further investigation by PET-CT scan of the whole body revealed a breast tumor.
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