A case of Kleine-Levin syndrome arising during chemotherapy: efficacy of oral L-carnitine.

Abstract

A woman in her 50 s with Kleine-Levin syndrome (KLS) was referred to our sleep clinic for recurrent episodes of sleep hypersomnia lasting for two to 3 days, despite attempts to remain awake. These episodes were unaccompanied by anxiety or depression, increased appetite, increased sex drive, irritability, or hallucinations, and had first appeared during chemotherapy for malignant lymphoma. Video polysomnography revealed mild obstructive sleep apnea syndrome (apnea-hypopnea index 7.9/h), but no other abnormalities. All blood tests and brain imaging investigations, including brain MRI and A 123I-ioflupane SPECT, yielded normal results. Oral L-carnitine was found to be effective for shortening the period of hypersomnolence, reducing the degree of hypersomnolence, and prolonging the inter-episode period. Since it has been reported that alkylating agents may induce carnitine deficiency, the present observations appear to support the involvement of carnitine in the onset of KLS.

• Authors: Ryuji Furihata, Daisuke Endo, Kenichi Nagaoka, Ayako Hori, Tatsuya Ito, Kazuo Chin, Toshiki Akahoshi
• Journal: Sleep and biological rhythms (Sleep Biol Rhythms) Vol. 21 Issue 2 Pg. 257-260 (Apr 2023) ISSN: 1446-9235 [Print] Japan
• PMID: 38469287 (Publication Type: Case Reports)
• Copyright: © The Author(s), under exclusive licence to Japanese Society of Sleep Research 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.