• The Journal of Korean Medicine
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• v.34 no.1
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• pp.179-191
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• 2013

Kleine-Levin syndrome is a rare disorder characterized by recurrent episodes of hypersomnia, hyperphagia, hypersexuality and delusion and hallucination with spontaneous recovery. A 17-year-old female suddenly showed hypersomnia, severe fatigue, and compulsive hyperphagia. She was diagnosed with suspected Kleine-Levin Syndrome. The precipitating factor was an upper respiratory tract infection that the patient had undergone 2 weeks prior. Past psychiatric history included somnambulism and ADHD; her symptoms of ADHD included attention deficit, impulsiveness, hyperactivity, and irritability. This was her third episode. Her hypersomnia was longer in duration but lower in frequency compared with usual KLS. Her low LF/HF ratio in heart rate variability measurement showed high parasympathetic nerve activity. A MMPI report showed some psychological problem. The patient was diagnosed of gastric fever by pattern identification. Her hypersomnia episode improved 6 weeks after onset. This is the first reported case of suspected Kleine-Levin Syndrome in the field of Oriental Medicine in Korea.

• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.79-84
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• 1996

Kleine-Levin syndrome is a disorder characterized by recurrent episodes of hypersomnia, hyperphagia and hypersexuality that typically occur weeks or months apart. A 17-years-old male showed these episodes and took nocturnal polysomnography(NPSG) and multiple sleep latency test(MSLT). As results of NPSG, sleep latency was 82.5min, sleep efficiency was 82.5min, sleep efficiency was 82.5%, latency and percentage of REM sleep were 106.5min and 14.6% and percentage of slow wave sleep was 12.7%. In 4 times MLST, average of sleep latency and REM latency were 8min 7sec and 5min 20sec with 3 times sleep onset REM period(SOREMP). These findings are consistent with these of Keine-Levin syndrome. And the possible causes and classification of this syndrome were discussed.

• Sleep Medicine and Psychophysiology
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• v.2 no.1
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• pp.91-96
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• 1995

A 24-year-old woman complained of recurrent episodes of hypersomnia lasting on the average about 15 days with mild mood alternation such as depression and irritability. During interepisode interval, she was free of any symptoms. Depending on the absence of excessive eating and hypersexuality, she was clinically diagnosed as recurrent monosymptomatic hypersomnia or the incomplete form of Kleine-Levin syndrome. When nocturnal polysomnography and multiple sleep latency test were performed 10 days after her recovery from a hypersomnic episode, reduced slow wave sleep % and pathologic daytime sleepiness were still noted. The authors suggest that the clinical recovery in recurrent monosymptomatic hypersomnia precede electrophysiological normalization by several days.

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.65-76
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• 1996

Natural sleep pattern and its physiology in childhood are much different from those in adulthood. Several aspects of clinical evaluation for sleepiness in childhood are more difficult than in adulthood. These difficulties are due to several factors. First, excessive sleepiness in childhood do not always develop functional impairments. Second, objective test such as MSLT may not be reliable since it is hard to be certain that the child understand instructions. Third, sleepiness in children is often obscured by irritability. paradoxical hyperactivity, or behavioral disturbances. Anseguently, careful clinical evaluation is needed for the sleepy children. Usual causes of sleepiness in children are the disorders that induce insufficient sleep such as sleep apnea syndrome, schedule disorder, underlying medical and psychiatric disorder, and so forth. After excluding such factors, we can diagnose the hypersomnic disorders such as narcolepsy, Kleine-Levin syndrome, and idiopathic central nervous system hypersomnia. Among the variety of those causes of sleepiness, I reviewed the clinical difference of narcolepsy and obstructive sleep apnea syndrome in childhood compared with in adulthood. Recognition of the childhood narcolepsy is difficult because even severely sleepy children often do not develop pathognomic cataplexy and associated REM phenomena until much later. Since childhood narcolepsy give srise to many psychological, academical problem. Practicers should be concerned about these aspects. Childhood obstructive sleep apnea syndrome is different from adult obstructive sleep apnea syndrome too. Several aspects such as pathophysiology. clinical feature, diagnostic criteria, complication, management, and prognosis differ from those in the adult syndrome. An important feature of childhood obstructive sleep apnea syndrome is the variety of severe complications such as behavioral disorders, cognitive impairment, cardiovascular symptoms, developmental delay, and ever death. Fortunately, surgical interventions like adenotosillectomy or UPPP are more effective for Childhood OSA than adult form. CPAP is a "safe, effective, and well-tolerated" treatment modality too. So if early detection and proper management of childhood OSA were done, the severe complication would be prevented or ever cured.