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Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia

Alice in Wonderland syndrome (AIWS) is a rarely curious visual perceptual disorder which has been associated with diverse neurologic and psychiatric problems. It may be a manifestation in migraine, epileptic seizures, encephalitis, other brain lesions, medication-related side effects, schizophrenia,...

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Autores principales: Panpruang, Pitirat, Wongwandee, Monton, Rattanajaruskul, Nattapun, Roongsangmanoon, Worawut, Wongsoasu, Arthit, Angkananard, Teeranan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8647104/
https://www.ncbi.nlm.nih.gov/pubmed/34950010
http://dx.doi.org/10.1159/000519509
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author Panpruang, Pitirat
Wongwandee, Monton
Rattanajaruskul, Nattapun
Roongsangmanoon, Worawut
Wongsoasu, Arthit
Angkananard, Teeranan
author_facet Panpruang, Pitirat
Wongwandee, Monton
Rattanajaruskul, Nattapun
Roongsangmanoon, Worawut
Wongsoasu, Arthit
Angkananard, Teeranan
author_sort Panpruang, Pitirat
collection PubMed
description Alice in Wonderland syndrome (AIWS) is a rarely curious visual perceptual disorder which has been associated with diverse neurologic and psychiatric problems. It may be a manifestation in migraine, epileptic seizures, encephalitis, other brain lesions, medication-related side effects, schizophrenia, and depressive disorders. Principal character of AIWS is the disproportion between the external world and the self-image in which micropsia (objects appear smaller), macropsia (objects appear larger), and teleopsia (objects appear further away) are frequently reported. The cases of temporal lobe epilepsy may present with complex visual auras of visual distortions (e.g., micropsia and macropsia) like AIWS. We report an unusual case of an elderly man who presented with AIWS, focal impaired awareness seizures, ictal tachyarrhythmia, multiple episodes of transient visual disturbances of macropsia and transient loss of consciousness. During those symptoms, telemetry showed self-limited supraventricular tachycardia several times which could not be regulated with heart rate-controlled medication. The electroencephalography was later tested and showed rhythmic theta activity over the right cerebral hemisphere. He was treated with levetiracetam, and all his symptoms and tachyarrhythmias were gradually resolved thereafter. Refractory response to treatment would remind the physicians to reassess for the correct diagnosis.
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spelling pubmed-86471042021-12-22 Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia Panpruang, Pitirat Wongwandee, Monton Rattanajaruskul, Nattapun Roongsangmanoon, Worawut Wongsoasu, Arthit Angkananard, Teeranan Case Rep Neurol Single Case − General Neurology Alice in Wonderland syndrome (AIWS) is a rarely curious visual perceptual disorder which has been associated with diverse neurologic and psychiatric problems. It may be a manifestation in migraine, epileptic seizures, encephalitis, other brain lesions, medication-related side effects, schizophrenia, and depressive disorders. Principal character of AIWS is the disproportion between the external world and the self-image in which micropsia (objects appear smaller), macropsia (objects appear larger), and teleopsia (objects appear further away) are frequently reported. The cases of temporal lobe epilepsy may present with complex visual auras of visual distortions (e.g., micropsia and macropsia) like AIWS. We report an unusual case of an elderly man who presented with AIWS, focal impaired awareness seizures, ictal tachyarrhythmia, multiple episodes of transient visual disturbances of macropsia and transient loss of consciousness. During those symptoms, telemetry showed self-limited supraventricular tachycardia several times which could not be regulated with heart rate-controlled medication. The electroencephalography was later tested and showed rhythmic theta activity over the right cerebral hemisphere. He was treated with levetiracetam, and all his symptoms and tachyarrhythmias were gradually resolved thereafter. Refractory response to treatment would remind the physicians to reassess for the correct diagnosis. S. Karger AG 2021-11-02 /pmc/articles/PMC8647104/ /pubmed/34950010 http://dx.doi.org/10.1159/000519509 Text en Copyright © 2021 by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Single Case − General Neurology
Panpruang, Pitirat
Wongwandee, Monton
Rattanajaruskul, Nattapun
Roongsangmanoon, Worawut
Wongsoasu, Arthit
Angkananard, Teeranan
Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia
title Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia
title_full Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia
title_fullStr Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia
title_full_unstemmed Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia
title_short Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia
title_sort alice in wonderland syndrome-like seizure and refractory supraventricular tachycardia
topic Single Case − General Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8647104/
https://www.ncbi.nlm.nih.gov/pubmed/34950010
http://dx.doi.org/10.1159/000519509
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