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From the Departments of Pathology & Laboratory Medicine (Drs. Koerber, Haven, Cohen. and Case), Pediatric Neurology (Dr. Torkelson), and Psychiatry (Dr. Donaldson), University of Nebraska Medical Center, Omaha, NE.
A 17-year-old man with the Kleine-Levin syndrome died unexpectedly of cardiopulmonary arrest during a period of autonomic instability that followed an episode of megaphagia. At autopsy, the only pertinent finding was mild depigmentation of the locus ceruleus and sub-stantia nigra. Premortem CSF levels of 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) levels were elevated. These findings I indicate that many symptoms of the Kleine-Levin syndrome are a result of a neurotransmitter imbalance in the serotonergic pathway of the brainstem.
Address correspondence and reprint requests to Dr. Koerber, Department of Pathology. Memorial Hospital of Dodge County. 23rd and Clarkson, Fremont. NE 68025.
Accepted for publication March 22, 1984.
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