Perioperative Considerations in a Patient with Kleine-Levin Syndrome Undergoing a Neurosurgical Procedure under General Anesthesia

Wesley Rajaleelan; Tumul Chowdhury; Rebecca Moga; Carla Todaro; Gelareh Zadeh; Justin Wang; Mandeep Singh

doi:10.1055/s-0042-1756624

Perioperative Considerations in a Patient with Kleine-Levin Syndrome Undergoing a Neurosurgical Procedure under General Anesthesia

Asian J Neurosurg. 2022 Oct 7;17(3):480-484. doi: 10.1055/s-0042-1756624. eCollection 2022 Sep.

Authors

Wesley Rajaleelan^{1

2}, Tumul Chowdhury^{1

2}, Rebecca Moga^{1

2}, Carla Todaro^{1

2}, Gelareh Zadeh³, Justin Wang³, Mandeep Singh^{1

2

4}

Affiliations

¹ Department of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada.
² Department of Anesthesia and Pain Management, Women's College Hospital, Toronto, Ontario, Canada.
³ Department of Neurosurgery, University Health Network, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada.
⁴ Toronto Sleep and Pulmonary Centre, Toronto, Ontario, Canada.

Abstract

Kleine-Levin syndrome (KLS) is a rare central disorder of daytime hypersomnolence and is often characterized by a relapsing and remitting course, recurrent episodes of excessive sleep lasting from 12 to 20 hours a day, and symptoms including hyperphagia, hallucinations, derealization, disorientation, and hypersexuality. There are numerous perioperative considerations in dealing with KLS that include challenges during induction of anesthesia, delayed emergence, postoperative sleep disorders, and delirium. However, due to its rare occurrence, the anesthetic considerations of KLS remain poorly described. This case report outlines the anesthetic considerations and management of a young female patient with KLS who underwent transnasal excision of a trigeminal schwannoma under general anesthesia.

Keywords: Kleine–Levin syndrome; narcolepsy; sleep disorders.

Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).

Publication types

Case Reports

Grants and funding

Funding Support was provided solely from institutional and/or departmental sources. MS is supported by the Canadian Anesthesiologists Society Career Scientist Award, as well as the Merit Awards Program from the Department of Anesthesia at the University of Toronto.