L-Carnitine use as a trigger for the onset of Kleine-Levin syndrome: A case presentation

Abstract

Kleine- Levin Syndrome (KLS) is a rare phenomenon characterized by repeating episodes of hypersomnia, cognitive and behavioral impairments, compulsive eating behavior, and hypersexuality. Postinfectious processes, alcohol consumption, sleep deprivation, psychological stress, getting vaccinated, head injury and genetic factors have been identified possible etiological factors. Abnormal metabolism of serotonin and dopamine have also been reported. Alcohol and cannabis have been listed among triggering factors. With its role as a mediator required to transport long-chain fatty acids to mitochondrial matrix and its contributions in increasing oxidation of fatty acids, L-carnitine helps to produce more energy from burning fat while maintaining economic use of muscle glycogen stocks. Animal studies have shown a continous increase in dopamine discharge within nucleus accumbens via acetyl L-carnitine application. Carnitine supplementation is known to cause increased dopamine levels within cortical, hippocampal and striatal regions of the rat brain. One case report reported severe psychotic symptoms in a patient with bipolar disorder, following acetyl L-carnitine use. In this case presentation, we have aimed to present clinical course of an adolescent using L-carnitine for ergogenic support, as a possible trigger for the onset of a KLS episode.