Alice in Wonderland syndrome: “Who in the world am I?”

ABSTRACT Alice in Wonderland syndrome (AIWS) is a paroxysmal, perceptual, visual and somesthetic disorder that can be found in patients with migraine, epilepsy, cerebrovascular disease or infections. The condition is relatively rare and unique in its hallucinatory characteristics. Objective: To discuss the potential pathways involved in AIWS. Interest in this subject arose from a patient seen at our service, in which dysmetropsia of body image was reported by the patient, when she saw it in her son. Methods: We reviewed and discussed the medical literature on reported patients with AIWS, possible anatomical pathways involved and functional imaging studies. Results: A complex neural network including the right temporoparietal junction, secondary somatosensory cortex, premotor cortex, right posterior insula, and primary and extrastriate visual cortical regions seem to be involved in AIWS to varying degrees. Conclusions: AIWS is a very complex condition that typically has been described as isolated cases or series of cases.摘要：爱丽丝梦游仙境综合征（Alice in Wonderland syndrome, AIWS）是一种发作性感知、视觉及躯体感觉障碍，可见于偏头痛、癫痫、脑血管疾病或感染患者。该病症相对罕见，其幻觉性特征具有独特性。研究目的：探讨AIWS潜在的发病通路。本研究对该主题的关注源于我科接诊的一例患者：该患者自述在观察其子时出现了躯体意象的视物变形。研究方法：我们回顾并讨论了已报道的AIWS患者相关医学文献、可能涉及的解剖通路及功能影像学研究。研究结果：包含右侧颞顶联合区、次级躯体感觉皮层、运动前皮层、右侧后岛叶以及初级与纹外视觉皮层区域的复杂神经网络，似乎在不同程度上参与了AIWS的发病过程。研究结论：AIWS是一种极为复杂的病症，以往通常仅被描述为散发病例或病例系列。