Episodic diencephalic hypoperfusion in Kleine-Levin syndrome.
A 22 year-old woman suffered from recurrent episodes of hypersomnia, apathy, and hyperphagia. The symptoms occurred 3 to 4 times per year, and each attack lasted 2 to 3 weeks. 99mTc-ethylcysteinate dimer brain single photon emission computed tomography (SPECT) was performed during symptomatic and asymptomatic periods. To localize brain regions with perfusion changes during symptomatic period, asymptomatic SPECT was subtracted from symptomatic SPECT. The subtracted SPECT showed significant hypoperfusion in the left hypothalamus, bilateral thalami, basal ganglia, bilateral medial and dorsolateral frontal regions, and left temporal lobe during the symptomatic period. These cerebral hypoperfusion areas support the diencephalic hypothesis and clinical symptoms of Kleine-Levin syndrome.
Hong
Seung Bong
SB
Department of Neurology, Samsung Medical Center, SBRI, Sungkyunkwan University School of Medicine, Seoul, Korea. seungbong.hong@samsung.com
Joo
Eun Yeon
EY
Tae
Woo Suk
WS
Lee
Jaewoo
J
Han
Sun Jung
SJ
Lee
Hyang Woon
HW
D000328:Adult; D004027:Diencephalon / Q000098:blood supply* / Q000000981:diagnostic imaging; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply; D006801:Humans; D007031:Hypothalamus / Q000098:blood supply / Q000000981:diagnostic imaging; D007091:Image Processing, Computer-Assisted; D017593:Kleine-Levin Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D009483:Neuropsychological Tests; D013382:Subtraction Technique; D013702:Temporal Lobe / Q000098:blood supply; D013788:Thalamus / Q000098:blood supply / Q000000981:diagnostic imaging; D015899:Tomography, Emission-Computed, Single-Photon; D014851:Wakefulness / Q000502:physiology