What is Alice in Wonderland syndrome (AiWS), also known as micropsia or Lilliputian hallucinations?

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From the Research

Alice in Wonderland Syndrome (AiWS) is a rare neurological disorder characterized by temporary distortions in visual perception, where people experience objects or their own body parts as appearing larger, smaller, closer, or farther away than they actually are, as reported in a study published in 2019 1. The syndrome typically affects children and young adults and often occurs before, during, or after migraine headaches or seizures. Episodes usually last minutes to hours and can be triggered by infections (particularly Epstein-Barr virus), stress, fatigue, or certain medications. Some key features of AiWS include:

  • Metamorphopsias, which are distortions of visual perception
  • Dysmetropsia, which is a distortion of body image
  • Alterations in the perception of space and time
  • The condition has many different etiologies, including migraine, epilepsy, and infections
  • The temporoparietal-occipital carrefour (TPO-C) is a key region for developing many of AiWS symptoms, as reported in a study published in 2016 2 Management of AiWS focuses on treating underlying causes like migraines or seizures with appropriate medications, as there is no specific treatment for the syndrome itself, and most people with this condition do not require medication specifically for the perceptual distortions, as they are temporary and not harmful 3, 4, 5. It is essential to note that while AiWS is generally considered to have a good prognosis with no long-term complications, it can be a symptom of a more severe underlying condition, such as Creutzfeldt-Jakob disease, as reported in a study published in 2019 1. Therefore, a thorough diagnostic evaluation is necessary to determine the underlying cause of AiWS and to provide appropriate treatment.

References

Research

Alice in wonderland syndrome in an elderly patient with focal onset epilepsy.

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 2020

Research

Alice in Wonderland syndrome: "Who in the world am I?".

Arquivos de neuro-psiquiatria, 2019

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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