Kleine-Levin Disease | Drauzio Varella

In Kleine-Levin syndrome, also known as Sleep Disorders, hypersomnia can last for hours, days, or weeks.

Kleine-Levin (SKL) syndrome, also known as “Sleeping Beauty Syndrome”, was named after a German legend who, under duress of an evil witch, was sentenced to sleep soundly until the princess woke her up. up for a kiss of love.

In medicine, the name signifies a rare neurological disorder, which is difficult to detect, known as Kleine-Levin syndrome, in honor of two scientists who attempted to explain the condition, which was classified as one of the different types of disease. hypersomnia.

See also: Sleep disorders

Among the main features of this disease of unknown origin, the following stand out: 1) the manifestation of recurrent and recurrent episodes of day or night sleep, which tend to disappear for years; 2) severe resistance to waking up and staying awake during the day; 3) an unknown disease that makes it difficult to define the diagnosis associated with the condition; 4) the magnitude of the crisis decreases over time; 5) good prognosis, although the method of definitive treatment is still unknown; 6) outbreaks, in general, last for about ten consecutive days and can recur every three or four months a year.

Conflicts of hypersomnia can last for hours, days or weeks, and are accompanied by uncontrollable mental and behavioral changes, which endanger the quality of life of the individual and those living with them, as well as impair the social, social and professional performance of patients. .of the state.

Kleine-Levin syndrome can manifest itself at any age, but it mainly affects young men and adolescents. Occasionally only women and the elderly are affected by the disease, which is associated with a common trio of the following symptoms: hypersomnia (excessive sleepiness), hyperphagia (forced eating), and open and intense sexual abuse.

Since there is still no effective treatment that promotes complete cure for the disease, clinical monitoring of patients with the disease has shown that the disease can disappear on its own, without medication or special care, around the age of 35/40.

Causes of Kleine-Levin syndrome

Kleine-Levin syndrome is a disease whose cause has not yet been identified (hence the term idiopathic or primary). Several hypotheses have already been raised that try to explain the nature of the disease, starting with being infected with a type of virus that recurs frequently.

Genetic, autoimmune and hereditary factors, head injuries and severe stress are other possible causes of the disease, which is still being studied.

Some research suggests that the presence of functional changes in certain areas of the brain (hypothalamusthe limbic system, thalamus and frontotemporal cortex, for example) may be related to sleep and mood control in patients with the disease.

Currently, the trend is to accept that the condition may have a genetic component and be associated with immune and environmental factors.

Symptoms Kleine-Levin syndrome

Frequent episodes of excessive sleep, appetite, and complete abstinence are the main symptoms of Kleine-Levin syndrome.

At the onset of the seizures, the period of hypersomnia can increase to hours and hours of intense, uninterrupted sleep. One wakes up only after much effort, using the bathroom and eating uncontrollably

Called “sleepless nights,” this transition from sleep to wakefulness can be slow and extremely confusing.

Even in times of disaster, in the short term when he is awake, serious behavioral changes can occur, manifested by extreme fatigue, apathy, mental confusion, impaired attention and concentration, impaired memory, irritability, loss of appetite, loss of restraint. sex and even dreams.

Another frequent complaint, in these cases, is the difficulty of distinguishing dream from reality, when one is trying to remember what happened during sleep (severe amnesia). It is also common that, during waking, there are displays of forced behavior, emotional lability and patients are very sensitive to noise and light.

It is important to note that, between one crisis and another, a person returns to normal behavior and resumes normal activities, as if he or she has never been affected by this sleep disorder. On the contrary, they appear to be doing well, enjoying perfect physical and mental health, and few are showing any signs of progressive mental illness.

See also: Sleep deprivation

Cognition Kleine-Levin syndrome

From a clinical point of view, the diagnosis of Kleine-Levin’s disease of unknown cause is carried out in isolation, preferably by an international team, led by a neurologist.

Therefore, laboratory blood tests and imaging tests (MRIultrasound, computer tomography) has been shown to be important in establishing different diagnoses and other pathologies that show similar symptoms.

In any case, the most reliable test to diagnose hypersomnia, in general, with Kleine-Levin syndrome, in particular, continues to be polysomnography, a non-invasive procedure that allows for quality assurance assessments and diagnosis of possible related complications.

To complete the diagnosis, it is important that the symptoms persist for at least one month and have a negative impact on the patient’s quality of life.

Treatment of Kleine-Levin syndrome

To date, there is no known effective treatment for Kleine-Levin syndrome, a rare disease with a low infection rate and an unknown cause. In the face of such evidence, scholars’ attention has been focused on the control and stability of symptoms. It is already known that it is possible to improve the quality of life of patients with this condition, by using certain stimulant drugs, such as amphetamines and antidepressants, which have shown some effectiveness in similar clinical conditions and in psychological symptoms.

With regard to medicinal resources, mood regulators and anticonvulsants may be part of a treatment regimen given for behavioral disorders associated with the disease. Instructions for lithium drugs in times of conflict have already been tried and proven to have a beneficial effect.

In times of crisis, it is part of treatment to allow a person to sleep, without interruption, as long as he or she deems it necessary.

However, despite the different approaches, the goal of treatment is still the same: reduce the duration of daytime sleepiness and extend, as far as possible, those in which one can remain completely awake.

Unfortunately, effective treatment of the disease is still difficult. However, recent studies indicate that a condition known as Sleeping Beauty syndrome is not as bad as previously thought. The current trend is to acknowledge that the condition has a genetic predisposition associated with immune and environmental factors.

Frequently asked questions about Kleine-Levin syndrome

What are the symptoms of Kleine-Levin syndrome?

Frequent periods of excessive sleep, appetite, and complete abstinence are the main symptoms of Kleine-Levin syndrome. During a heart attack, during a period of alertness, significant behavioral changes, extreme fatigue, apathy, mental confusion, impaired concentration and concentration, memory, irritability, loss of appetite, loss of sexual arousal and even vision loss.

In addition, there are also problems in distinguishing dreams from reality and displays of forced behavior, emotional lability and sensitivity to noise and light.

What are the causes of Kleine-Levin syndrome?

Kleine-Levin syndrome is a disease caused by an unknown cause. Currently, the trend is to accept that the condition may have a genetic component and be associated with immune and environmental factors.

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