A Sleepy, Hungry Teenager

A 16-year-old male was admitted for repeated episodes of hypersomnia, hyperphagia, and abnormal behavior, the first of which was preceded by alcohol and marijuana use. He was started on lithium therapy and lethargy and hyperphagia gradually improved, although he remained oppositional and irritable. After careful evaluation, his symptoms were concluded to meet Critchley's criteria for the diagnosis of Klein-Levin syndrome, which was supported by his response to prophylactic use of lithium.