Further observations on sleep abnormalities in Kleine-Levin syndrome: Abnormal breathing pattern during sleep

Lavie, Peretz; Klein, Erez; Gadoth, Natan; Bental, E; Zomer, J; Bechar, M; Wajsbort, J

doi:10.1016/0013-4694(81)90194-2

Cited by 18 publications

(7 citation statements)

References 7 publications

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“…In a few cases, a large or first alcohol consumption or marijuana use on an evening was followed by the first episode the following morning (Wilkus and Chiles, 1975;Chiles and Wilkus, 1976;Mayer et al, 1998;Janicki et al, 2001;Landtblom et al, 2002Landtblom et al, , 2003. Head trauma, including a knock-out during boxing (Smolik and Roth, 1988;Will et al, 1988;Janicki et al, 2001), physical exertion and psychological distress (Kellett, 1977;Masi et al, 2000;Arias et al, 2002), surgery with general or local (dental) anaesthesia, lactation and menses (Lavie et al, 1981), but not at menarche, and not as in menstruation-linked hypersomnia (Gilbert, 1964;Duffy and Davison, 1968;Papy et al, 1982;Shukla et al, 1982;Janicki et al, 2001) were other factors occasionally reported at KLS onset. Events triggering subsequent episodes were described in only 27 cases (Table 1) and contained a similarly high proportion of infections (fever, sore throat or zoster before each episode in five patients).…”

Section: Precipitating Factors and Infectionsmentioning

confidence: 99%

Kleine–Levin syndrome: a systematic review of 186 cases in the literature

Arnulf¹,

Zeitzer²,

File³

et al. 2005

Brain

353

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Kleine-Levin syndrome (KLS) is a rare disorder with symptoms that include periodic hypersomnia, cognitive and behavioural disturbances. Large series of patients are lacking. In order to report on various KLS symptoms, identify risk factors and analyse treatment response, we performed a systematic review of 195 articles, written in English and non-English languages, which are available on Medline dating from 1962 to 2004. Doubtful or duplicate cases, case series without individual details and reviews (n = 56 articles) were excluded. In addition, the details of 186 patients from 139 articles were compiled. Primary KLS cases (n = 168) were found mostly in men (68%) and occurred sporadically worldwide. The median age of onset was 15 years (range 4-82 years, 81% during the second decade) and the syndrome lasted 8 years, with seven episodes of 10 days, recurring every 3.5 months (median values) with the disease lasting longer in women and in patients with less frequent episodes during the first year. It was precipitated most frequently by infections (38.2%), head trauma (9%), or alcohol consumption (5.4%). Common symptoms were hypersomnia (100%), cognitive changes (96%, including a specific feeling of derealization), eating disturbances (80%), hypersexuality (43%), compulsions (29%), and depressed mood (48%). In 75 treated patients (213 trials), somnolence decreased using stimulants (mainly amphetamines) in 40% of cases, while neuroleptics and antidepressants were of poor benefit. Only lithium (but not carbamazepine or other antiepileptics) had a higher reported response rate (41%) for stopping relapses when compared to medical abstention (19%). Secondary KLS (n = 18) patients were older and had more frequent and longer episodes, but had clinical symptoms and treatment responses similar to primary cases. In conclusion, KLS is a unique disease which may be more severe in female and secondary cases.

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Section: Precipitating Factors and Infectionsmentioning

confidence: 99%

Kleine–Levin syndrome: a systematic review of 186 cases in the literature

Arnulf¹,

Zeitzer²,

File³

et al. 2005

Brain

353

300

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“…Since Critchley’s review, only a few case reports have added new data on the syndrome, particularly with respect to sleep structure (Lavie et al. 1979, 1981), and hormonal secretory patterns (Chesson et al. 1991; Fernandez et al.…”

Section: Introductionmentioning

confidence: 99%

Clinical and polysomnographic characteristics of 34 patients with Kleine–Levin syndrome

Gadoth

Kesler

Vainstein

et al. 2001

Journal of Sleep Research

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There is only scant information on sleep characteristics and long-term follow-up in patients with Kleine-Levin syndrome (KLS). This study describes the clinical course, results of polysomnography and long-term follow-up in a relatively large group of patients with KLS. During the years 1982-97, we encountered 34 patients (26 males and eight females) with KLS. We were able to obtain the original polysomnographs from 28 males and four females. In 25 patients, data regarding their present state of health were obtained. Fourteen agreed to be present at a detailed interview and examination while 11 gave the information by phone. The mean age at onset was 15.8 +/- 2.8 years and the mean diagnostic delay, 3.8 +/- 4.2 years. The mean duration of a single hypersomnolent attack was 11.5 +/- 6.6 days. The main abnormal findings extracted out of 35 polysomnographs obtained from 32 patients during and/or in-between attacks included: decreased sleep efficiency, and frequent awakenings from sleep stage 2. All 25 patients reported present perfect health, with no evidence of behavioral or endocrine dysfunction. In adolescents with periodic hypersomnia, the diagnosis of KLS should be explored. Sleep recordings during a hypersomnolent period will often show frequent awakenings from sleep stage 2. The long-term prognosis is excellent.

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“…The presence of periodical respiration during the N1 and N2 phases and central apnea in patients with KLS has been described. However, they were not associated with CO 2 retention, suggesting a possible hypo-excitability of the respiratory center [10,11] .…”

Section: Discussionmentioning

confidence: 79%

Kleine–Levin Syndrome: A case report

et al. 2014

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The Kleine–Levin Syndrome is a differential diagnosis for patients with diurnal excessive sleepiness and a suspicion of narcolepsy. It is characterized by paroxysmal attacks of diurnal excessive sleepiness, associated with one or more symptoms of hyperphagia, hypersexuality, coprolalia and copropraxia. During crisis intervals, there are no symptoms. This pathology predominantly manifests itself in teenagers, being more frequent among males. The course of this disease is unpredictable, with variable duration and frequency. The most accepted physiopathology is that of a hypothalamic dysfunction, although and recently, there has appeared a hypothesis of a post-infectious autoimmune disorder. These patients show an elevated body mass index, which can predispose to association with comorbidities such as the sleep obstructive apnea syndrome. Treatment involves medications with different effects, but there is no specific and effective therapy. Our article shows a classic case of Kleine–Levin Syndrome associated with sleep obstructive apnea syndrome, a rare association in the literature.

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Further observations on sleep abnormalities in Kleine-Levin syndrome: Abnormal breathing pattern during sleep

Cited by 18 publications

References 7 publications

Kleine–Levin syndrome: a systematic review of 186 cases in the literature

Kleine–Levin syndrome: a systematic review of 186 cases in the literature

Clinical and polysomnographic characteristics of 34 patients with Kleine–Levin syndrome

Kleine–Levin Syndrome: A case report

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