Takayanagi Masaru, Okabe Shinichi, Yamamoto Katsuya, Komatsu Juri, Suzuki Rikio, Kitamura Taro, Ohura Toshihiro
Division of Pediatrics, Sendai City Hospital, Sendai, Miyagi, Japan.
Okabe Clinic, Sendai, Miyagi, Japan.
Pediatr Int. 2017 Aug;59(8):929-931. doi: 10.1111/ped.13326.
Kleine-Levin syndrome is a rare sleep disorder of unknown etiology characterized by repetitive episodes of hypersomnia between asymptomatic periods. We report the case of a 13-year-old girl who presented with drowsiness triggered by influenza A as the first episode. Magnetic resonance imaging (MRI) on day 6 showed transient reduction of diffusion in the corpus callosum splenium. The patient was diagnosed with encephalopathy with a reversible splenial lesion. The symptoms resolved after 10 days, but additional episodes of hypersomnia lasting 5-10 days occurred 1, 5, 6, 11, 13, and 25 months after the first episode. MRI during hypersomnia indicated no lesions, and sleep duration and cognition were normal between episodes. The patient was diagnosed with Kleine-Levin syndrome. Electroencephalographic and clinical findings during the first episode were similar to those during the other episodes. Encephalopathy with a splenial lesion and Kleine-Levin syndrome may have similar pathological mechanisms causing a disturbance in consciousness.
克莱恩-莱文综合征是一种病因不明的罕见睡眠障碍，其特征是在无症状期之间反复出现发作性嗜睡。我们报告了一例13岁女孩的病例，她首次发作是由甲型流感引发的嗜睡。第6天的磁共振成像（MRI）显示胼胝体压部的扩散短暂减少。该患者被诊断为伴有可逆性胼胝体压部病变的脑病。症状在10天后缓解，但在首次发作后的1、5、6、11、13和25个月出现了持续5至10天的额外发作性嗜睡。发作性嗜睡期间的MRI显示无病变，发作间期的睡眠时间和认知功能正常。该患者被诊断为克莱恩-莱文综合征。首次发作期间的脑电图和临床 findings 与其他发作期间相似。伴有胼胝体压部病变的脑病和克莱恩-莱文综合征可能具有相似的病理机制，导致意识障碍。 （注：原文中“findings”未翻译，可能是笔误，推测应为“发现”之类的意思，这里按原文保留。）
