title: Episodic diencephalic hypoperfusion in Kleine-Levin syndrome.
abstract: 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.
authors.affiliation: Department of Neurology, Samsung Medical Center, SBRI, Sungkyunkwan University School of Medicine, Seoul, Korea. seungbong.hong@samsung.com
authors.forename: Seung Bong
authors.initials: SB
authors.lastname: Hong
authors.forename: Eun Yeon
authors.initials: EY
authors.lastname: Joo
authors.forename: Woo Suk
authors.initials: WS
authors.lastname: Tae
authors.forename: Jaewoo
authors.initials: J
authors.lastname: Lee
authors.forename: Sun Jung
authors.initials: SJ
authors.lastname: Han
authors.forename: Hyang Woon
authors.initials: HW
authors.lastname: Lee
mesh_terms: 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