The Kleine-Levin syndrome and the treatment with methylphenidate

A 17-year-old man was referred to the Med-Psych-Unit because of recurrent episodes of hypersomnia, megaphagia, hypersexual behaviour and cognitive disturbances. Over the period of three years he suffered more than 10 episodes of hypersomnia each lasting 8 to 16 days. The clinical presentation was suggestive of the Kleine-Levin syndrome. The symptoms disappeared after treatment with methylphenidate, but it was not clear whether this could be attributed to the medication or to the self-limiting character of the illness. The Kleine-Levin syndrome is often clinically not recognised due to the variation in the symptoms and the lack of objective diagnostic examination.