title: A case of Kleine-Levin syndrome examined with SPECT and neuropsychological testing.
abstract: A case of Kleine-Levin syndrome with typical periodic hypersomnia and bulimia was diagnosed. On examination with single photo emission tomography (SPECT) (CERETEC) during a relapse period and 2 weeks later there was marked cortical hypoperfusion of the frontal and temporal lobes, especially on the left side as well as in the right parietal lobe. Neuropsychological testing performed 1 week after a relapse showed a reduction in encoding to memory function of verbal learning indicating neocortical damage of the left fronto-temporal region. A follow-up 2 months later after the patient had spontaneously recovered showed only a slight left fronto-temporal disturbance. CT and MRI of the brain were normal although the MRI showed a large and asymmetric mamillary body. Neuropsychological testing 6 years after recovery showed pronounced reduction in short-time verbal and visual memory. Seven years after recovery SPECT demonstrated a normalized frontal perfusion but still a slight hypoperfusion in the left temporal lobe. Our results correlate to autopsy findings in two cases described previously.
authors.affiliation: Department of Neuroscience and Locomotion, Linköping University Hospital, Linköping, Sweden. Anne-Marie.Landtblom@lio.se
authors.forename: A-M
authors.initials: AM
authors.lastname: Landtblom
authors.forename: N
authors.initials: N
authors.lastname: Dige
authors.forename: K
authors.initials: K
authors.lastname: Schwerdt
authors.forename: P
authors.initials: P
authors.lastname: Säfström
authors.forename: G
authors.initials: G
authors.lastname: Granérus
mesh_terms: D000293:Adolescent; D018450:Disease Progression; D006970:Disorders of Excessive Somnolence / Q000503:physiopathology; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006963:Hyperphagia / Q000503:physiopathology; D017593:Kleine-Levin Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D013702:Temporal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon; D014706:Verbal Learning