Between Neurology and Psychiatry, a Difficult Preliminary Diagnosis of Kleine-levin Syndrome: Case-report of a Young Girl

Kleine-Levin syndrome appears suddenly, sometimes without a triggering factor or sometimes being precipitated by an infection (38.2%), head trauma (9%) or acute consumption of alcohol (5.4%) [2-5]. The etiology remains unclear, but there may be a genetic predisposition (haplotype HLA-DR1), associated with environmental factors [6,7]. The syndrome is characterized by hypersomnia (up to 20 hours a day), cognitive symptoms (mainly derealisation, but also confusion, delusions, and/or hallucinations, memory impairments), behavioral symptoms (sexual disinhibition, irritability/aggression, compulsive eating), and mental symptoms such as depression and anxiety [4,8-13]. There are also physical signs such as autonomic dysfunction, weight gain; and at the end of the episodes, amnesia, elation, and depression. It is important to underline that these symptoms and signs are generally not combined in a single patient. The average length of an episode is 8 to 10 days, and episodes lasting several months are relatively exceptional. They usually recover after a period of about 8 years.