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Updated: 6:52 p.m. Wednesday, Sept. 27, 2006 | Posted: 1:35 p.m. Wednesday, Sept. 27, 2006
By Bob Bruce
PITTSBURGH —
Most of us think that fable is pure fiction, but for one young Pittsburgh area girl and her family it's all too real.
Ten-year-old Nicole Delien appears happy and healthy, but at any time she can fall victim to a rare and debilitating disorder that causes her to sleep for days and weeks at a time.
Harry Delien, Nicole's father, said that when Nicole does awaken during these episodes she's in a trance and behaves strangely.
"She does a lot of child-like mannerism, a lot of repetitive things. A lot of obsession, a lot of hallucinations."
Her mother, Vicki Delien , sees a huge difference in her daughter's personality.
"She's normally smiling and somewhat bashful, very outgoing. When she's in an episode she just kind of stares blankly. She's not even ticklish. She falls asleep constantly while in episode and isn't interested in playing with anyone," Vicki Delien said.
Stranger still, when she comes to, she doesn't remember anything that has happened.
Nicole has Kleine-Levine Syndrome.
Allegeheny General psychiatrist Dr. Dr. Michael Rancurello has seen only four cases of this rare condition.
He said it's still very unclear just what causes Kleine-Levine, but there are some clues.
"It appears it arises in the hypothalamus or thalamus, which is a deep brain structure that serves as a kind of switching station for all kinds of input and output. It's a vital area that regulates sleep, appetite and sex drive," Rancurello said.
The disorder usually hits adolescent boys. For Nicole it began in 2002 when she started sleeping for hours. She ended up in a hospital's intensive care unit and despite a battery of tests, doctors couldn't figure out what was wrong.
Harry Delien explained what happened a week later: "She woke up one morning, she smiled and was her normal self and had no memory of previous week."
After that Nicole began having episodes almost monthly.
Her condition baffled doctor after doctor. One physician thought the Deliens were the causing her problem and reported them to Allegheny County Children and Youth Services.
Vicki Delien was angry and scared.
"Luckily, we had video tape and we had medical records and kept a diary about Nicole and her episodes, so the case was closed in two months," she said.
Rancurello said he was skeptical when he saw his first case of Kleine-Levin, "The first person I saw with this was a teenage boy and I initially thought he was pulling my leg."
The teen's behavior soon convinced the doctor this was no stunt.
"I had no idea what was wrong with him, but there was something wrong that I'd never seen before," Rancurello said.
A year later he learned about Kleine-Levin syndrome by accident. "I stumbled on letter to editor in a journal. I don't know why I read it. I started reading it and they described exactly what this kid had. That was the first I knew of it."
When Nicole ended up in Rancurello's office, he knew immediately what was wrong.
It was a relief to finally have a doctor who actually knew what was wrong, but it wasn't the answer her parents hoped for.
"We had a name for it, but there is still no cure," Vicki Delien said. "You're still playing around with medication after medication. Trying to figure out, maybe this will help and if this doesn't help where will we go next."
The disorder has taken a toll on the whole family. Vicki Delien can no longer work.
She said,”I can't leave the house when she's like that, unless I have my husband with me."
Rancurello said the mother's reaction is very common. In all four cases he's seen, all the mothers have had to stop working.
"These guys are a handful for anyone. Parents get fatigued, demoralized you can't leave a kid in an episode like this without someone who's in eye sight range of them at all times."
Nicole was in an episode when her brother turned one. She doesn't remember the birthday party, but her mom does.
She said Nicole awoke during the party and, "She actually devoured about three-quarters of the cake. She'd wake up and just go in there and start eating. She's eating a lot in these episodes."
Rancurello said such behavior is not unusual for children with Kleine-Levine syndrome.
Nicole now takes several pills a day and the medications have helped some. She went for almost seven months without an episode. But this summer she began having episodes almost every month.
Nicole continues to lose huge chunks of her life to sleep.
Rancurello said she might outgrow it, but no one really knows what the outcome will be.
One of his patients seemed to have successfully overcome the syndrome, going two years without an episode only to relapse as he prepared to go away to college.
"You have to worry every minute of every day that it's going to happen again very hard to plan," Rancurello said.
It's something that troubles Nicole's mother.
"My worries are that she's not going to be able to do the things she wants to. Holding down a job, getting married and having kids. I don't think she'll have a lot of that," Vicki DeLein said.
More Info: - Kleine-Levine Foundation
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