Atypical Symptoms in Migraine-Related Alice in Wonderland Syndrome: Expansion of the Phenotype and Reflection on the Pathomechanism

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  • Matsuura Kazuki
    *Department of Ophthalmology, Nojima Hospital, Kurayoshi 682-0863, Japan
  • Ishikura Ryoko
    †Department of Ophthalmology, Tottori University Hospital, Yonago 683-8504, Japan
  • Oguri Masayoshi
    ‡Department of Pathobiological Science and Technology, School of Health Science, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
  • Saito Yoshiaki
    ¶Division of Child Neurology, Department of Brain and Neurosciences, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan

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<p>We report an 8-year-old girl who experienced daily episodes of visual and somesthetic distortion and was diagnosed with Alice in wonderland syndrome (AIWS). Ophthalmologic assessment revealed best-corrected visual acuity of 0.2 in both eyes, and bilateral constricted tubular or spiral visual fields. Augmented amplitude of visually evoked potentials was revealed, and treatment with lomerizine and valproate showed favorable effect on the visual/somesthetic distortion as well as the visual field and acuity. Psychogenic visual problems can co-exist with the typical sensory distortion in AIWS, similarly to the case of psychogenic pseudo-seizures in subjects with epilepsy. Otherwise, an ambiguous borderline between psychological and physical pathomechanisms in migraine may also be characteristic of the migraine-related AIWS.</p>

収録刊行物

  • Yonago Acta Medica

    Yonago Acta Medica 62 (1), 163-165, 2019

    ヨナゴ・アクタ・メディカ刊行会

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