Alice in Wonderland Syndrome (AIWS). A reflection

Palacios-Sánchez, Leonardo; Botero-Meneses, Juan Sebastián; Mora-Muñóz, Laura; Guerrero-Naranjo, Alejandro; Moreno-Matson, María Carolina; Pachón, Natalia; Charry-Sánchez, Jesús David

doi:10.1097/cj9.0000000000000026

Cited by 4 publications

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a study carried out with 3224 subjects between 13 to 18 years old, the occurrence of micropsia and macropsia was 6.5% and 7.3% in males and females. This suggests that visual illusions in AIWS are not as infrequent as usually believed" [5].…”

Section: Discussionmentioning

confidence: 70%

The Mental Health Syndrome Known as Alice in Wonderland - A Case Report

Hernandez¹

2022

INDJ

View full text Add to dashboard Cite

The Alice in Wonderland Syndrome (AIWS) is a rare neurological and psychiatric condition, represented as the appearance of disorienting perceptual disorder with occasional episodes of bizarre visual illusions and spatial distortions. It was first introduced by John Todd in 1955, based on the literary chronicles of the strange encounters described by Lewis Carroll in Alice in Wonderland books. A 30-year-old healthy male presented to the doctor’s office with left-sided headaches lasting 24 hours and preceded by an aura. During these auras, the patient was experiencing erratic behaviors consistent with the phenomena experienced by Alice, the main character in the world-famous story. He reported objects being larger and further away than they really were and his hands appearing smaller than they really were. Symptoms lasted up to 45 minutes. All clinical and diagnostic workups and evaluations were unremarkable, and the patient was treated for migraines with auras using Valproic Acid. During his follow-up at 3 months intervals, the patient continued with symptoms, and his medication dosage was increased. In his next follow-up three months later, he described having no more symptoms. AIWS has been found to be related to migraines with preceding auras. It is both common in pediatrics as well as in adults. I present an AIWS case co-existent with aura migraines.

show abstract

Section: Discussionmentioning

confidence: 70%

The Mental Health Syndrome Known as Alice in Wonderland - A Case Report

Hernandez¹

2022

INDJ

View full text Add to dashboard Cite

show abstract

“…A future VHI study could, for instance, be conducted, in which participants that have already experienced clinical manifestations of micro-or macrosomatognosia would be surveyed about the phenomenological similarities or differences between their pathologically-induced and experimentally-induced aberrant body size perceptions. Our suspicion is that the negative affective stance and fear of body size misperception that often accompanies the clinical cases of micro-and macrosomatognosia (Tunç and Başbug, 2017;Palacios-Sánchez et al, 2018) was not induced by our experiment. Instead, our participants were not worried, but rather curious about their altered body experiences.…”

Section: Limitations and Future Directionsmentioning

confidence: 80%

Experimental Induction of Micro- and Macrosomatognosia: A Virtual Hand Illusion Study

Anders

Berisha

Selaskowski

et al. 2021

Front. Virtual Real.

View full text Add to dashboard Cite

Although body size misperceptions are known to occur under various neurological and psychiatric conditions, their neurocognitive underpinnings are not yet resolved. Accordingly, it would be beneficial to have an experimental paradigm, by which aberrant body misperceptions could be induced and systematically investigated. Expanding upon the “Virtual Hand Illusion” (VHI), this study aimed to design such a paradigm. Using a body-motion tracking system, we translated the participant's real hand position and movements to an embodiable, but resizable virtual hand model that we presented to the participants via a head-mounted display. The virtual hand's size was then systematically shrunk and enlarged in five different conditions (i.e., −50%, −25%, 0%, +25% or +50% rescaling). Applying this VHI derivate on n = 35 healthy participants, we investigated (1) if participants experience Sense of Ownership (SoO) and Sense of Agency (SoA) over a virtual hand that significantly deviates in size from their own hand, and (2) if by such size-deviant VHI induction, a change in their own hand size perception is also induced. Virtual hand embodiment was explicitly and implicitly assessed by means of self-report and EDA analysis. Questionnaire results revealed a stable SoA across all hand size conditions, while SoO parametrically decreased according to the hand scaling factor in either direction. Hand size perception, in turn, adapted according to the hand-scaling factor. In conclusion, the present study provides an important step toward an experimental paradigm that can induce and investigate aberrant body-size misperceptions.

show abstract

“…This is especially true when symptoms severely disrupt one's sensory perception, interfere with one's daily functioning, and/or evoke catastrophic thoughts (e.g., that the world has actually changed in an incomprehensible way or that symptoms may be indicative of dementia or schizophrenia). Since non-clinical cases are by definition self-limiting, and even in 50% of all clinical cases, reassurance would seem to suffice, AIWS is sometimes characterized as relatively harmless in nature (9). However, since research in this area is still in its infancy, and AIWS may well be severely underreported, it is too soon to draw any conclusions regarding its natural history and “typical” outcome.…”

Section: Introductionmentioning

confidence: 99%

Alice in Wonderland Syndrome as a Presenting Manifestation of Creutzfeldt-Jakob Disease

et al. 2019

View full text Add to dashboard Cite

Background: Alice in Wonderland syndrome (AIWS) is a rare neurological disorder characterized by distortions of visual perception (metamorphopsias), the body image, and the experience of time, along with derealization and depersonalization. Some 85% of patients present with perceptual distortions in a single sensory modality, e.g., only visual or only somesthetic in nature. Moreover, the majority experience only a single type of distortion, e.g., only micropsia or only macropsia. AIWS has many different etiologies, and hence an extensive differential diagnosis. Its amenability to treatment depends on the underlying pathological process, which in children is mostly encephalitis, and in adults, migraine. In the literature, no more than 180 “clinical” cases of AIWS have been described (i.e., cases in need of medical attention). Of them, some 50% showed a favorable prognosis. However, non-clinical cases (i.e., fleeting, transient cases of AIWS for which no professional help is needed) have been described in up to 30% of the general population. This indicates that AIWS is perhaps not as rare as traditionally assumed, and has led some authors to conclude that, prognostically, AIWS is usually harmless. Methods: From our own clinical practice, we describe the first known case of Creutzfeldt-Jakob Disease (CJD, Heidenhain variant) that presented with symptoms of AIWS. Results: In our patient, disease onset was sudden and rapidly progressive, starting with isolated visual symptoms. Symptoms of AIWS comprised akinetopsia, chloropsia, micropsia, macropsia, zoom vision, and time distortions (quick-motion phenomenon and protracted duration). Soon, these were complicated by paraesthesias, gait instability, aphasia, expressive amusia, cognitive decline, and behavioral changes in the form of agitation and emotional lability. The diagnosis of probable sporadic CJD was confirmed with the aid of a head MRI and cerebrospinal fluid (14-3-3 protein). In the absence of any treatment options, our patient was discharged home and died within 2 months after his visual symptoms had begun. Autopsy consent was not obtained. Conclusion: We conclude that AIWS is not always as harmless as sometimes suggested, and that CJD, although extremely rare, must be part of its extensive differential diagnosis, notably in the presence of rapid cognitive decline.

show abstract

Alice in Wonderland Syndrome (AIWS). A reflection

Cited by 4 publications

References 13 publications

The Mental Health Syndrome Known as Alice in Wonderland - A Case Report

The Mental Health Syndrome Known as Alice in Wonderland - A Case Report

Experimental Induction of Micro- and Macrosomatognosia: A Virtual Hand Illusion Study

Alice in Wonderland Syndrome as a Presenting Manifestation of Creutzfeldt-Jakob Disease

Contact Info

Product

Resources

About