Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia

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: Pitirat Panpruang, Monton Wongwandee, Nattapun Rattanajaruskul, Worawut Roongsangmanoon, Arthit Wongsoasu, Teeranan Angkananard
Formato: article
Lenguaje:EN
Publicado: Karger Publishers 2021
Materias:
macropsia
seizure
tachycardia
alice in wonderland
Neurology. Diseases of the nervous system
RC346-429
Acceso en línea:https://doaj.org/article/58d6cd29c75f480696b2714b91d297ee
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spelling oai:doaj.org-article:58d6cd29c75f480696b2714b91d297ee2021-11-25T07:47:20ZAlice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia1662-680X10.1159/000519509https://doaj.org/article/58d6cd29c75f480696b2714b91d297ee2021-11-01T00:00:00Zhttps://www.karger.com/Article/FullText/519509https://doaj.org/toc/1662-680XAlice 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.Pitirat PanpruangMonton WongwandeeNattapun RattanajaruskulWorawut RoongsangmanoonArthit WongsoasuTeeranan AngkananardKarger Publishersarticlemacropsiaseizuretachycardiaalice in wonderlandNeurology. Diseases of the nervous systemRC346-429ENCase Reports in Neurology, Vol 13, Iss 3, Pp 716-723 (2021)
institution DOAJ
collection DOAJ
language EN
topic macropsia
seizure
tachycardia
alice in wonderland
Neurology. Diseases of the nervous system
RC346-429
spellingShingle macropsia
seizure
tachycardia
alice in wonderland
Neurology. Diseases of the nervous system
RC346-429
Pitirat Panpruang
Monton Wongwandee
Nattapun Rattanajaruskul
Worawut Roongsangmanoon
Arthit Wongsoasu
Teeranan Angkananard
Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia
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.
format article
author Pitirat Panpruang
Monton Wongwandee
Nattapun Rattanajaruskul
Worawut Roongsangmanoon
Arthit Wongsoasu
Teeranan Angkananard
author_facet Pitirat Panpruang
Monton Wongwandee
Nattapun Rattanajaruskul
Worawut Roongsangmanoon
Arthit Wongsoasu
Teeranan Angkananard
author_sort Pitirat Panpruang
title Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia
title_short 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_sort alice in wonderland syndrome-like seizure and refractory supraventricular tachycardia
publisher Karger Publishers
publishDate 2021
url https://doaj.org/article/58d6cd29c75f480696b2714b91d297ee
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AT nattapunrattanajaruskul aliceinwonderlandsyndromelikeseizureandrefractorysupraventriculartachycardia
AT worawutroongsangmanoon aliceinwonderlandsyndromelikeseizureandrefractorysupraventriculartachycardia
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