Reddy Balaswamy, Prasad Sakshi, Das Soumitra
Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, Kerala, India.
Faculty of Medicine, National Pirogov Memorial Medical University, Vinnytsia, Ukraine.
SAGE Open Med Case Rep. 2022 Jul 12;10:2050313X221110985. doi: 10.1177/2050313X221110985. eCollection 2022.
Kleine-Levin syndrome (KLS) is an extremely rare relapsing-remitting neuropsychiatric condition characterized by recurrent incidents of major hypersomnolence along with hyperphagia, hypersexual behavior, and mood or cognitive disturbances alternating with asymptomatic periods. Here, we present a case of a young male chiefly presenting with recurring episodes of acute onset behavioral changes. The patient's episodes were characterized by repetitive incidents of prolonged sleep for more than 20 h, followed by social withdrawal and apathy. He was diagnosed with KLS because of the periodic patterns of hypersomnolence accompanied by other cognitive and mood disturbances and lacked characteristics of central hypersomnolence disorders or atypical depression. There are varying success rates among medications such as lithium, stimulants such as modafinil, antiepileptics such as carbamazepine and valproate. Similarly, the use of antidepressants such as tricyclic agents and selective serotonin reuptake inhibitors has largely been negative. Our case report addresses a patient with KLS who was successfully treated with 20 mg of Escitalopram.
克莱恩-莱文综合征(KLS)是一种极为罕见的发作-缓解型神经精神疾病,其特征为反复出现严重的嗜睡,并伴有贪食、性欲亢进、情绪或认知障碍,且发作期与无症状期交替出现。在此,我们报告一例主要表现为急性起病的行为改变反复发作的年轻男性病例。该患者的发作特点为反复出现长达20多个小时的长时间睡眠,随后出现社交退缩和淡漠。由于其嗜睡发作具有周期性,同时伴有其他认知和情绪障碍,且缺乏中枢性嗜睡障碍或非典型抑郁症的特征,故诊断为KLS。锂盐、莫达非尼等兴奋剂、卡马西平和丙戊酸盐等抗癫痫药物的治疗成功率各不相同。同样,三环类药物和选择性5-羟色胺再摄取抑制剂等抗抑郁药的使用效果大多不佳。我们的病例报告介绍了一名成功使用20毫克艾司西酞普兰治疗的KLS患者。