PT  - JOURNAL ARTICLE
AU  - Liu, Grant
AU  - Liu, Alessandra
AU  - Liu, Jonathan
AU  - Liu, Geraldine
TI  - Alice in Wonderland Syndrome: Presenting and Follow-up Characteristics (S19.003)
DP  - 2014 Apr 08
TA  - Neurology
PG  - S19.003
VI  - 82
IP  - 10 Supplement
4099  - http://n.neurology.org/content/82/10_Supplement/S19.003.short
4100  - http://n.neurology.org/content/82/10_Supplement/S19.003.full
SO  - Neurology2014 Apr 08; 82
AB  - OBJECTIVE: To investigate the distribution of symptoms and etiologies of patients with Alice in Wonderland syndrome (AWS) (change in one’s body size) and AW-like syndrome (AWLS) (extrapersonal illusions) at presentation and to determine their prognosis. BACKGROUND: Alice in Wonderland is an uncommon condition. There is very little published from any large cohort re: presenting and followup characteristics DESIGN/METHODS: Retrospective chart review and telephone interview. Charts of children diagnosed with AWS by a pediatric neuro-ophthalmologist between July 1993 to July 2013 were reviewed. Patients seen prior to 2012, or their parents, were contacted for follow-up information. RESULTS: 48 patients (avg. age 8.1 years) diagnosed with AWS/AWLS were identified. Common visual symptoms were micropsia (69%), teleopsia (50%), macropsia (25%), metamorphopsia (15%), and pelopsia (10%). MRI and EEGs were unrevealing in 21/21 and 23/23 cases respectively. The etiology was infection in 33% and migraine and head trauma in 6% each. No cause was found in 52%. Of the 15 patients with follow-up, 20% had a few more events of AWS/AWLS which eventually stopped after initial diagnosis, 40% had no more events, and 40% were still having AWS/AWLS symptoms at the time of the interview, while 4 (27%) developed migraines and 1 (7%) seizures since the diagnosis. CONCLUSIONS: AWS/AWLS typically affects young children, and the most common visual complaints are micropsia and teleopsia. The most common cause is infection, but half of cases have no obvious etiology. MRI and EEG are unhelpful. Usually symptoms of AWS/AWLS stop eventually, but in over one third of the cases, they continue. One third of patients without a history of migraine may subsequently develop migraine. Study Supported by:Disclosure: Dr. Liu has received personal compensation for activities with Ipsen as a consultant. Dr. Liu has nothing to disclose. Dr. Liu has nothing to disclose. Dr. Liu has nothing to disclose.Tuesday, April 29 2014, 3:15 pm-5:00 pm