Billiard M, Cadilhac J
Unité des Troubles du Sommeil, Centre Médical Gui de Chauliac, Montpellier.
Rev Neurol (Paris). 1988;144(4):249-58.
Recurring hypersomnias are described according to 3 etiological groups: 1) idiopathic - the Kleine Levin syndrome and its clinical variants - 2) organic and 3) psychiatric. The typical form of the Kleine Levin syndrome is remarkable for the association of recurring episodes of sleep, overeating and temporary mental disturbances lasting from a few hours to several days. Its diagnosis is mainly based on clinical data Laboratory investigations have so far failed to document specific features. Emphasis is laid on circumstances at onset and pathological studies which could be in favour of a viral origin. Some clinical aspects and polysomnographic features are reminiscent of endogenous depression. The treatments of hypersomniac episodes based on stimulants are often disappointing. On the other hand, the prevention of the hypersomniac episodes of the Kleine Levin syndrome with lithium carbonate has been successful in several well-documented cases as well as the prevention of the hypersomniac episodes of the menstruation related hypersomnia with ovulatory inhibitors. Organic and psychiatric forms of recurring hypersomnias are not well known. Their clinical features are described and their various possible etiologies indicated.
复发性嗜睡症根据3种病因分类：1）特发性——克莱恩-莱文综合征及其临床变异型——2）器质性和3）精神性。克莱恩-莱文综合征的典型形式以反复出现睡眠发作、暴饮暴食和持续数小时至数天的短暂精神障碍为显著特征。其诊断主要基于临床资料，迄今为止实验室检查未能证实其特异性特征。重点在于发病时的情况以及可能支持病毒起源的病理研究。某些临床方面和多导睡眠图特征使人联想到内源性抑郁症。基于兴奋剂治疗嗜睡发作往往令人失望。另一方面，在一些有充分记录的病例中，用碳酸锂预防克莱恩-莱文综合征的嗜睡发作取得了成功，用排卵抑制剂预防与月经相关的嗜睡症的嗜睡发作也取得了成功。复发性嗜睡症的器质性和精神性形式并不为人熟知。文中描述了它们的临床特征并指出了各种可能的病因。
