Pharmacological treatment for Kleine-Levin Syndrome

Oliveira MM, Conti C, Saconato H, Fernandes do Prado G

Published Online:

September 8, 2010

Kleine-Levin Syndrome (KLS) is a rare disorder which mainly affects adolescent men. It is characterized by recurrent episodes of hypersomnia (excessive sleepiness), hyperphagia (over eating) and abnormal behavior. The frequency and nature of the attacks can disrupt the individual's social, professional and family life. The cause of Kleine-Levin Syndrome is not known. Several treatments have been used, including stimulant, antiepileptic, antidepressant and antipsychotic drugs, with some benefit reported, but due to the rarity of the condition, long-term follow up of patients is difficult.

The authors of this review aimed to identify and evaluate randomized controlled trials (RCTs) studying the effectiveness of pharmacological treatment for Kleine-Levin Syndrome. We were not able to find any RCTs. Good quality evidence is therefore lacking and therapeutic trials with a double-blind, placebo-controlled design are needed.

Abstract (click to read)

Background:

This is an updated version of the original Cochrane review published in Issue 2, 2009.

Kleine-Levin Syndrome (KLS) is a rare disorder which mainly affects adolescent men. It is characterized by recurrent episodes of hypersomnia, usually accompanied by hyperphagia, cognitive and mood disturbances, abnormal behavior such as hypersexuality, and signs of dysautonomia.

In 1990 the diagnostic criteria for Kleine-Levin Syndrome were modified in the International Classification of Sleep Disorders, where it was defined as a syndrome composed of recurring episodes of undue sleepiness lasting some days, which may or may not be associated with hyperphagia and abnormal behavior.

The etiology of Kleine-Levin Syndrome remains unknown and several treatment strategies have been used. Some medications have been reported to provide some benefit for the treatment of Kleine-Levin Syndrome patients, but because of the rarity of the condition no long-term follow-up therapies have yet been described.

Objectives:

This review aimed to evaluate:

1. whether pharmacological treatment for Kleine-Levin Syndrome is effective and safe; and
2. which drug or category of drugs is effective and safe.

Search strategy:

We obtained relevant trials from the following sources: the Cochrane Epilepsy Group Specialized Register (5 March 2010); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library February issue, 2010); MEDLINE (1950 to March week 1, 2010); LILACS (1982 to March 2010); reference lists of sleep medicine textbooks; review articles and reference lists of articles identified by the search strategies.

Selection criteria:

All randomized controlled trials (RCTs) and quasi-randomized controlled trials looking at pharmacological interventions for Kleine-Levin Syndrome. We included both parallel group and cross-over studies.

Data collection and analysis:

Two review authors (MO and CC) extracted the data reported in the original articles.

Main results:

No studies met the inclusion criteria for this systematic review.

Authors' conclusions:

Therapeutic trials of pharmacological treatment for Kleine-Levin Syndrome, with a double-blind, placebo-controlled design are needed.

This record should be cited as:

Oliveira MM, Conti C, Saconato H, Fernandes do Prado G. Pharmacological treatment for Kleine-Levin Syndrome. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD006685. DOI: 10.1002/14651858.CD006685.pub2

Assessed as up to date:

March 5, 2010

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Primary Review Group:

Epilepsy Group

Health topics:

Neurology > Sleep disorders > Kleine-Levin Syndrome

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Pharmacological treatment for Kleine-Levin Syndrome

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