Alice in Wonderland Syndrome (AIWS): prevalence and characteristics in adults with migraine
- Open Access
- 31-05-2024
- Migraine
- Original Communication
Published in:
- Authors
- Mira P. Fitzek
- Jasper Mecklenburg
- Lucas H. Overeem
- Kristin S. Lange
- Anke Siebert
- Paul Triller
- Lars Neeb
- Jens P. Dreier
- Daniel Kondziella
- Uwe Reuter
- Bianca Raffaelli
- Published in
- Journal of Neurology | Issue 8/2024
Abstract
Objective
Alice in Wonderland Syndrome (AIWS) is a sensory disorder characterized by a distorted somatosensory and/or visual perception. Additionally, distortion of time perception and symptoms of derealization/depersonalization may occur. AIWS is frequently associated with migraine. However, its prevalence, and clinical characteristics remain poorly understood. Here, we investigated the prevalence and features of AIWS in individuals with migraine. We hypothesized AIWS is more frequent in migraine patients with aura than in those without aura.
Methods
This was a prospective cross-sectional cohort study, conducted at a tertiary headache center. Participants with migraine filled out questionnaires, providing details on demographics, headache, AIWS characteristics and the occurrence of transient visual phenomena such as fragmented vision.
Results
Of 808 migraine patients, 133 individuals (16.5%, mean age 44.4 ± 13.3 years, 87% women) reported AIWS symptoms throughout their lives. Micro- and/or telopsia (72.9%) were most frequent, followed by micro- and/or macrosomatognosia (49.6%), and macro- and/or pelopsia (38.3%), lasting on average half an hour. AIWS symptoms occurred in association with headache in 65.1% of individuals, and 53.7% had their first AIWS episode at the age of 18 years or earlier. Migraine patients with aura were more likely to report AIWS symptoms than those without aura (19.5% vs. 14.1%, p = 0.04). Participants with AIWS reported a higher incidence of 17 out of the 22 investigated visual phenomena.
Conclusion
AIWS symptoms appear to be a common lifetime phenomenon in migraine patients. The correlation and clinical parallels between AIWS and migraine aura could indicate shared underlying pathomechanisms.
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- Title
- Alice in Wonderland Syndrome (AIWS): prevalence and characteristics in adults with migraine
- Authors
-
Mira P. Fitzek
Jasper Mecklenburg
Lucas H. Overeem
Kristin S. Lange
Anke Siebert
Paul Triller
Lars Neeb
Jens P. Dreier
Daniel Kondziella
Uwe Reuter
Bianca Raffaelli
- Publication date
- 31-05-2024
- Publisher
- Springer Berlin Heidelberg
- Published in
-
Journal of Neurology / Issue 8/2024
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459 - DOI
- https://doi.org/10.1007/s00415-024-12471-5
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