It is now recognised that megaphagia or compulsive eating, rather than morbid hunger, is a cardinal manifestation of the syndrome. The urge to sleep is reported to be profound and patients may sleep for days or weeks at a stretch, awakening only to eat or to evacuate the bowel or bladder. The sleep episodes which may have associated prodromes, tend to recur. The period between episodes varies from days to months.3 Psychiatric disturbances in behaviour, mood and thinking have been reported to occur during episodes. Behavioural symptoms recognised to occur include lethargy, sexual disinhibition, apathy, withdrawal, truculence, agitation, social disinhibition, inappropriate singing, slurred speech, screaming, poor hygiene, muteness, bizarre movements, decreased sex drive, wandering and fire setting.
Mood disturbances described are irritability, depression, euphoria and lability.
Confusion, amnesia, delusions, thought blocking, vivid dreams, auditory and visual hallucinations have been described during the episodes. The duration of the episodes may range, from a few days to several weeks with normal inter-episodic periods lasting a few days to several months. The true prevalence of this syndrome in those with learning disability or for that matter in the general population is unknown due to lack of epidemiological data. Outcomes of treatment for this syndrome are yet to be fully evaluated. He was living with his parents who are physically healthy and caring and supportive towards him.