Shortening Kleine-Levin Syndrome Episodes With Oral Steroids: Insights From Two Cases

Kleine-Levin syndrome (KLS) is a rare sleep disorder marked by recurrent episodes of hypersomnia, cognitive impairment, and behavioral disturbances. Intravenous corticosteroids have been reported to shorten episodes, but evidence for oral steroid therapy remains limited. We describe two patients with KLS whose episodes improved with oral prednisone. Case 1 was a 17-year-old male patient with recurrent hypersomnia and behavioral changes. Steroid-responsive encephalopathy associated with autoimmune thyroiditis was initially considered but later excluded. He demonstrated improvement with intravenous steroids, and subsequent episodes were managed with oral prednisone. Case 2 was a 10-year-old male patient with early-onset KLS who experienced shortened episode duration after oral prednisone following failure of carbamazepine therapy. These cases suggest that oral prednisone may represent an effective alternative to intravenous corticosteroids for reducing episode duration in KLS. Oral therapy provides several advantages, including patient convenience and the feasibility of outpatient care. Therefore, oral steroid therapy warrants further investigation in KLS.