A 16-year-old boy has recurrent episodes lasting several days each, occurring every few months, in which he sleeps up to 18 hours a day, eats excessively, and behaves disinhibitedly with hypersexuality. Between episodes he is completely normal. What is the most likely diagnosis?
- A Kleine-Levin syndrome ✓
- B Idiopathic hypersomnia
- C Narcolepsy type 1
- D Atypical depression
Correct answer: A. Kleine-Levin syndrome
Explanation
Kleine-Levin syndrome is a rare recurrent hypersomnia of adolescent males featuring episodic hypersomnia lasting days to weeks, accompanied by hyperphagia, hypersexuality, and cognitive or behavioural disturbance, with completely normal function between episodes. Idiopathic hypersomnia causes daily sleepiness without discrete episodic relapses, and narcolepsy lacks hyperphagia and hypersexual behaviour.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.
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