Kleine-Levin Syndrome - Diagnosis

Diagnosis

Diagnosis of KLS is very difficult since there are no symptoms that allow for a positive diagnosis. KLS is instead a diagnosis of exclusion, where a doctor must first eliminate a long list of other conditions that could mimic the symptoms. Because hypersomnia is the primary symptom, many patients are initially treated for a sleeping disorder. Potential KLS patients are often referred to an endocrinologist early on to check for metabolic problems including diabetes and hypothyroidism. Several other disorders can also mimic KLS symptoms, but many can be positively diagnosed by MRI—including ones caused by a lesion, tumor, or inflammation. Multiple sclerosis also has neurological components that can mimic the symptom profile for KLS.

People with KLS are often mistakenly diagnosed with a psychiatric disorder. The periods of somnolence, hyperphagia, and withdrawal can mimic severe depression, and some people experience a brief period of high energy following these episodes which looks like a manic episode, so that some patients are incorrectly diagnosed with bipolar disorder. There can also be a number of other mood symptoms or perceptual disturbances which mimic primary psychiatric disorders. Narcolepsy and Klüver–Bucy syndrome can also produce similar symptom profiles. Before a final diagnosis can be made, all other possibilities must be carefully excluded, and the cluster of symptoms must fit with those commonly observed in KLS patients.