Kleine-Levin syndrome and psychosis: observation from an unusual case.
OBJECTIVE
This study evaluated the possible pathologic relation between Kleine-Levin syndrome (KLS) and mood disorders.


BACKGROUND
A 28-year-old man with a remote history of KLS had the sudden onset of a manic episode with psychotic features after the end of hypersomnolence.


METHODS
The patient received an extensive laboratory examination, including single photon emission computed tomography and magnetic resonance imaging.


RESULTS
Single photon emission computed tomography showed decreased tracer perfusion in the basal ganglion, hypothalamus, and right frontotemporal region. Magnetic resonance imaging revealed a cystic lesion in the pineal region.


CONCLUSIONS
Hypothalamic dysfunction has been described in KLS and mood disorders, but pineal gland dysfunction has been mentioned only rarely. The clinical and neuroimaging findings suggest the need for further study of KLS.
Lu
M L
ML
Department of Adult Psychiatry, Taipei City Psychiatry Center, and Shin Kong Wu Ho-Su Memorial Hospital, Taiwan.
Liu
H C
HC
Chen
C H
CH
Sung
S M
SM
D000328:Adult; D001479:Basal Ganglia / Q000098:blood supply / Q000503:physiopathology; D001927:Brain Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D015897:Comorbidity; D003560:Cysts / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology; D005625:Frontal Lobe / Q000098:blood supply / Q000503:physiopathology; D006801:Humans; D007031:Hypothalamus / Q000098:blood supply / Q000503:physiopathology; D017593:Kleine-Levin Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D010870:Pineal Gland / Q000503:physiopathology; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012039:Regional Blood Flow / Q000502:physiology; D013702:Temporal Lobe / Q000098:blood supply / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data