Alice in Wonderland Syndrome (AIWS): prevalence and characteristics in adults with migraine
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Alice in Wonderland Syndrome (AIWS) : prevalence and characteristics in adults with migraine. / Fitzek, Mira P.; Mecklenburg, Jasper; Overeem, Lucas H.; Lange, Kristin S.; Siebert, Anke; Triller, Paul; Neeb, Lars; Dreier, Jens P.; Kondziella, Daniel; Reuter, Uwe; Raffaelli, Bianca.
In: Journal of Neurology, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Alice in Wonderland Syndrome (AIWS)
T2 - prevalence and characteristics in adults with migraine
AU - Fitzek, Mira P.
AU - Mecklenburg, Jasper
AU - Overeem, Lucas H.
AU - Lange, Kristin S.
AU - Siebert, Anke
AU - Triller, Paul
AU - Neeb, Lars
AU - Dreier, Jens P.
AU - Kondziella, Daniel
AU - Reuter, Uwe
AU - Raffaelli, Bianca
N1 - Publisher Copyright: © The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - Cortical spreading depolarization
KW - Headache
KW - Migraine aura
KW - Visual phenomena
U2 - 10.1007/s00415-024-12471-5
DO - 10.1007/s00415-024-12471-5
M3 - Journal article
C2 - 38822148
AN - SCOPUS:85195116804
JO - Deutsche Zeitschrift fur Nervenheilkunde
JF - Deutsche Zeitschrift fur Nervenheilkunde
SN - 0939-1517
ER -
ID: 394524090