Kleine-Levin syndrome associated with fire setting
P. S. Powers and R. Gunderman
Kleine-Levin syndrome is characterized by periodic hypersomnia associated
with megaphagia and striking behavioral and psychiatric symptoms; it occurs
primarily in adolescent boys. We treated a 17-year-old boy who had typical
recurring somnolent episodes. His bizarre behavior included fire setting
and stealing, both of which may have represented compulsions. His EEG
during a sleepy episode was diffusely abnormal with generalized slowing of
background activity; as he awoke and improved clinically, his EEG returned
to normal. Between episodes, his EEG was normal. The relationship between
Kleine-Levin syndrome and other sleep disorders is discussed. The
neurochemistry and neurocircuitry that may provide the requisite substrate
for this complex and fascinating neuropsychiatric disorder are briefly
reviewed.
