{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:19:08Z","timestamp":1791357548222,"version":"4.3.1"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,2,4]],"date-time":"2015-02-04T00:00:00Z","timestamp":1423008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002738","name":"Assistance Publique H\u00f4pitaux de Paris","doi-asserted-by":"publisher","award":["PHRC AOM07-138"],"award-info":[{"award-number":["PHRC AOM07-138"]}],"id":[{"id":"10.13039\/501100002738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Kleine\u2013Levin syndrome is a rare disease characterized by recurrent episodes of hypersomnia with behavioral and cognitive disturbances. We aimed at describing the diagnosis procedure, risk factors, and severe forms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In consecutive patients referred for suspected Kleine\u2013Levin syndrome, we detailed differential diagnoses, and atypical and secondary cases, compared typical patients with healthy subjects, and examined the characteristics of patients with prolonged (&gt;30 days) episodes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 166 referred patients, 120 had typical primary Kleine\u2013Levin syndrome (syndrome secondary to brain diseases; n\u2009=\u20094, atypical syndrome, n\u2009=\u20097; differential diagnoses that were mostly psychiatric, n\u2009=\u200929; incomplete information, n\u2009=\u20096). The prevalence in France was 1.8 per million. The patients were often male (64%) and had more frequent birth and developmental abnormalities (45%) than controls (despite normal karyotypes), and most (80%) had teenage onset, with no difference between patients with prolonged (n\u2009=\u200934) and short (n\u2009=\u200985) episodes. In patients with prolonged episodes, the durations of the first episode (32\u2009\u00b1\u200933 vs 11\u2009\u00b1\u20096 days) and subsequent episodes were longer (mean episode duration\u2009=\u200923\u2009\u00b1\u200919 vs 10\u2009\u00b1\u20093 days) and the disease course tended to be longer (9\u2009\u00b1\u20096 vs 6\u2009\u00b1\u20094 years). During episodes, patients with prolonged episodes had shorter sleep time, higher levels of anxiety, increased agitation, and more feelings of disembodiment and amnesia. Between episodes, they were more tired, needed more naps, fell asleep more rapidly, and had higher anxiety\/depression scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Mental disorders are frequent differential diagnoses of Kleine\u2013Levin syndrome. One\u2010third of patients have prolonged (&gt;1 month) episodes with more frequent immediate and long\u2010term consequences of the disease, prompting therapeutic trials. Ann Neurol 2015. Ann Neurol 2015;77:529\u2013540<\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.24350","type":"journal-article","created":{"date-parts":[[2015,1,5]],"date-time":"2015-01-05T23:51:12Z","timestamp":1420501872000},"page":"529-540","source":"Crossref","is-referenced-by-count":79,"title":["<scp>K<\/scp>leine\u2013<scp>L<\/scp>evin syndrome in 120 patients: Differential diagnosis and long episodes"],"prefix":"10.1002","volume":"77","author":[{"given":"Sophie","family":"Lavault","sequence":"first","affiliation":[{"name":"Sleep Disorders Unit Piti\u00e9\u2010Salp\u00eatri\u00e8re University Hospital, Public Hospital Network of Paris  Paris"},{"name":"Brain Research Institute Sorbonne Universities Pierre and Marie Curie University  Paris"},{"name":"National Reference Center: Narcolepsy Hypersomnia, and Kleine\u2013Levin Syndrome  Paris"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Louis","family":"Golmard","sequence":"additional","affiliation":[{"name":"Sleep Disorders 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Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Arnulf","sequence":"additional","affiliation":[{"name":"Sleep Disorders Unit Piti\u00e9\u2010Salp\u00eatri\u00e8re University Hospital, Public Hospital Network of Paris  Paris"},{"name":"Brain Research Institute Sorbonne Universities Pierre and Marie Curie University  Paris"},{"name":"National Reference Center: Narcolepsy Hypersomnia, and Kleine\u2013Levin Syndrome  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