Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Junior Clinician Scientist Program, Berlin Institute of Health at Charité (BIH), Berlin, Germany.
J Neurol. 2024 Aug;271(8):5146-5155. doi: 10.1007/s00415-024-12471-5. Epub 2024 May 31.
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.
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.
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.
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.
爱丽丝梦游综合征（AIWS）是一种以感觉扭曲为特征的感觉障碍，表现为躯体感觉和/或视觉感知扭曲。此外，还可能出现时间感知扭曲和现实感丧失/人格解体症状。AIWS 常与偏头痛有关。然而，其患病率和临床特征仍知之甚少。在此，我们研究了偏头痛患者中 AIWS 的患病率和特征。我们假设，有先兆偏头痛患者比无先兆偏头痛患者更易发生 AIWS。
这是一项在三级头痛中心进行的前瞻性横断面队列研究。偏头痛患者填写问卷，提供人口统计学、头痛、AIWS 特征以及短暂视觉现象（如碎片化视觉）发生情况的详细信息。
在 808 例偏头痛患者中，有 133 例（16.5%，平均年龄 44.4 ± 13.3 岁，87%为女性）报告了一生中的 AIWS 症状。最常见的是微/和/或长视错觉（72.9%），其次是微/和/或大小错觉（49.6%）和大/和/或长视错觉（38.3%），平均持续半小时。65.1%的患者 AIWS 症状与头痛相关，53.7%的患者首次 AIWS 发作发生在 18 岁或更早。有先兆偏头痛患者比无先兆偏头痛患者更易报告 AIWS 症状（19.5% vs. 14.1%，p = 0.04）。有 AIWS 的参与者报告了 22 种调查视觉现象中的 17 种发生率更高。
AIWS 症状似乎是偏头痛患者一生中常见的现象。AIWS 与偏头痛先兆之间的相关性和临床相似性可能表明存在共同的潜在病理机制。
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