Depression and Mania Associated with Kleine-Levin-Critchley Syndrome

This is the fortieth reported case of K-L-C syndrome in the world and the second case reported in Canada. A study of this particular case, together with a review of the literature, is presented to clarify the phenomenology of this syndrome. Three aspects are emphasized: a) The presence of this syndrome in women is confirmed although the male-female ratio is 9:1. b) Rather than occurring in schizoid persons, as previously suggested, the syndrome is in fact an affective disorder which is closely related to manic-depressive psychosis, which may also have periods of delirium or pre-delirium associated with the hypersomnia spells. c) The occasional temporal association of a disorder of sleeping and eating, with menstruation and often accompanied by evidence of organicity, suggests a diencephalic problem. The further association of this disorder with affective changes suggests that manic-depressive psychosis should be considered as a possible disease of the diencephalon, rather than as a ‘functional’ psychosis with diencephalic signs.