Mumbai man’s 8-day sleep baffles doctors

Unravelling the enigma of a sleep disorder that strikes once a decade

An unusual and rare case that neurologists might encounter only once in a decade, if at all, has recently been reported at a private hospital in Mumbai. A 26-year-old man was diagnosed with Kleine-Levin Syndrome (KLS) after displaying symptoms such as sleeping for eight days straight, waking up only to eat excessively and pass stools. KLS is a complex condition, and its exact cause is not fully understood. The patient's family initially sought answers from local quacks and babas before consulting his neurologist, Dr Prashant Makhija at Wockhardt hospital. This was the third case he had seen in his career.

“The last two were ten years ago. There are no obvious causes for this disorder, but there are possible triggers like a viral infection, although nothing conclusive,” he said. The condition is diagnosed only after ruling out other conditions through extensive medical tests and clinical evaluation. There is no specific test to diagnose KLS itself.

While the disorder has mainly been observed in adolescents and young adults, typically between the ages of 12 and 25, there have also been older individuals diagnosed with this condition. At BMC-run BYL Nair hospital, neurologist Dr Rahul Chakor mentioned that about a decade ago, a man well into his 40s was diagnosed with KLS at the hospital. “My patient slept for three days," he said, adding that in medical school decades ago, he was taught about KLS as the ‘Kumbhakarna syndrome’.

In both cases, the patients dropped out of consultations. It’s worth noting that those diagnosed with KLS experience symptoms at least once a year; Dr Makhija's patient last experienced a KLS episode in December, and his visit to the hospital was in July. KEM's dean and head of the neurology department, Dr Sangeeta Ravat, said, “Wherever there is no etiology found, finding a cure is very difficult. That is the basics of medical science.”

Etiology refers to the causes or origins of diseases or disorders. Dr Neena S Sawant, a professor at KEM’s psychiatry department, has seen only two cases of KLS in her career, and that was two decades ago when she worked at Sion hospital. “One of them occurred while someone was menstruating,” she said. “There was also a case at KEM in an adolescent child who had ten episodes of excessive sleeping for a week each year, but he dropped out of treatment before we could further investigate and report it,” Dr Sawant added.

All four doctors noted that it is possible that the occurrence of KLS exists at a slightly larger level than it is reported, but because people are unaware of its existence, it is rarely reported. “There is also no specific treatment at the moment, and we only try to minimise the symptoms,” Dr Chakor added.

In the recent case, Dr Makhija said he prescribed stimulants like Modafinil to help with excessive sleeping, but that too is not as effective. “There is still no way to improve cognitive abilities during episodes of KLS,” Dr Makhija said. However, he noted that the syndrome tends to resolve on its own in the long term, which can take a few years.

26
Age of the patient

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