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Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2003-.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet].

Pharmacological treatment for Kleine‐Levin syndrome

This version published: 2013; Review content assessed as up-to-date: August 07, 2013.

Plain language summary

Kleine‐Levin syndrome (KLS) is a rare disorder that mainly affects adolescent men. It is characterised by recurrent episodes of hypersomnia (excessive sleepiness), hyperphagia (overeating) and abnormal behavior. The frequency and nature of the attacks can disrupt the individual's social, professional and family life. The cause of KLS is not known. Several treatments have been used, including stimulant, anti‐epileptic, anti‐depressant and anti‐psychotic drugs, with some benefit reported, but because of the rarity of the condition, long‐term follow up of participants is difficult.

The authors of this review aimed to identify and evaluate randomised controlled trials (RCTs) studying the effectiveness of pharmacological treatment for Kleine‐Levin syndrome. We were not able to find any RCTs. Good‐quality evidence is therefore lacking, and therapeutic trials with a double‐blind, placebo‐controlled design are needed.

Abstract

Background: This is an updated version of the original Cochrane review, published in Issue 2, 2009.

Kleine‐Levin syndrome (KLS) is a rare disorder that mainly affects adolescent men. It is characterised by recurrent episodes of hypersomnia, usually accompanied by hyperphagia, cognitive and mood disturbances, abnormal behavior such as hypersexuality and signs of dysautonomia.

In 1990 the diagnostic criteria for Kleine‐Levin syndrome were modified in the International Classification of Sleep Disorders, where KLS was defined as a syndrome composed of recurring episodes of undue sleepiness lasting some days, which may or may not be associated with hyperphagia and abnormal behavior.

The cause of Kleine‐Levin syndrome remains unknown, and several treatment strategies have been used. Some medications have been reported to provide benefit in the treatment of patients with KLS, but because of the rarity of the condition, no long‐term follow‐up therapies have yet been described.

Objectives: This review aimed to evaluate:

1. whether pharmacological treatment for Kleine Levin syndrome is effective and safe.

2. which drug or category of drugs is effective and safe.

Search methods: We obtained relevant trials from the following sources: the Cochrane Epilepsy Group Specialized Register (2 May 2013); the Cochrane Central Register of Controlled Trials (CENTRAL Issue 4, The Cochrane Library, April 2013); MEDLINE (1946 to 2 May 2013); SCOPUS (2 May 2013); LILACS (2 May 2013); ClinicalTrials.gov (2 May 2013); WHO International Clinical Trials Registry Platform ICTRP (2 May 2013); reference lists of sleep medicine textbooks; review articles and reference lists of articles identified by the search strategies.

Selection criteria: All randomised controlled trials (RCTs) and quasi‐randomised controlled trials looking at pharmacological interventions for Kleine‐Levin syndrome were selected. We included both parallel‐group and cross‐over studies.

Data collection and analysis: Two review authors (MMO and CC) extracted the data reported in the original articles.

Main results: No studies met the inclusion criteria for this systematic review.

Authors' conclusions: Therapeutic trials of pharmacological treatment for Kleine‐Levin syndrome with a double‐blind, placebo‐controlled design are needed.

Editorial Group: Cochrane Epilepsy Group.

Publication status: New search for studies and content updated (no change to conclusions).

Citation: Oliveira MM, Conti C, Prado GF. Pharmacological treatment for Kleine‐Levin syndrome. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD006685. DOI: 10.1002/14651858.CD006685.pub3. Link to Cochrane Library. [PubMed: 23945927]

Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

PMID: 23945927

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