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A case of Kleine–Levin syndrome examined with SPECT and neuropsychological testing

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A case of Kleine–Levin syndrome with typical periodic hypersomnia and bulemia 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.

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Keywords: Kleine–Levin syndrome; neuropsychological testing; single photo emission tomography (SPECT)

Document Type: Original Article

Affiliations: 1: Department of Neuroscience and Locomotion Linköping University Hospital, Linköping, Sweden, 2: Department of Clinical Physiology, Faculty of Health Sciences, Linköping University Hospital, Linköping, Sweden

Publication date: 2002-04-01

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