Through the Looking Glass: A Literature Review of a Rare Pediatric Neuropsychiatric Condition: Alice in Wonderland (Todd’s) Syndrome

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Published: Nov 2, 2015
DOI: https://doi.org/10.18192/uojm.v5i2.1281
Keywords:
Todd’s Syndrome, Alice in Wonderland Syndrome, hallucinations

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Brittany Harrison
University of Ottawa Faculty of Medicine
Adrienne Harrison
McMaster University

Abstract

ABSTRACT:

Alice in Wonderland Syndrome (AIWS), a.k.a Todd’s Syndrome, is a neuropsychiatric disorder characterized by a collection of rare, visually distortive symptoms such as micropsia, telopsia, macropsia, metamorphosia, pelospia, impaired passage of time and zooming of the environment. This article aims to review and organize the relevant articles written on AIWS, including a summary of the original research on etiology, imaging, comorbidities and treatments of AIWS, as well as historical accounts of cases from the 1950s, when it was first described. The articles included in this review were collected via the databases PubMed, SCOPUS and MedLine; a total of 18 articles were reviewed. Articles that were not in English were omitted from this review. Articles were not restricted by date of publication, as the goal was to incorporate the historical references of AIWS. In summary, AIWS is mainly a pediatric phenomenon, though there have been cases of comorbidity with depression and Lyme disease in adults. The syndrome is seen to be associated with infection, trauma, and migraine headaches. Imaging studies have discovered areas of hypo-perfusion in certain areas of the brain during episodes of AIWS; these areas mainly include the occipital lobe, but there are reports of frontal and temporal hypo-perfusion as well. This is a rare and interesting neuropsychiatric syndrome that presents with unique visual hallucinations. In the pediatric population, it may be a sign of undiagnosed viral infection that warrants further testing.


RÉSUMÉ:

Le Syndrome d’Alice au pays des merveilles (AIWS), aussi connu sous le nom de Syndrome de Todd, est un trouble neuropsychiatrique caractérisé par une multitude de symptômes rares, de distorsion visuelle tels que la micropsie, telopsie, macropsie, metamorphosie, pelospie, troubles de passage du temps et le zoom de l’environnement. Cet article vise à examiner et organiser les articles pertinents écrits sur AIWS, y compris un résumé de la recherche originale sur l’étiologie, l’imagerie, les comorbidités et les traitements d’AIWS, ainsi que les comptes historiques de cas à partir des années 1950, quand le syndrome a été décrit pour la première fois. Les articles inclus dans cette étude ont été assemblés via les bases de données PubMed, SCOPUS et MedLine ; un total de 18 articles a été examiné. Les articles non-rédigés en anglais ont été omis de cette revue. Les articles n’ont pas été limités par date de publication, car l’objectif était d’incorporer les références historiques d’AIWS. En résumé, AIWS est un phénomène essentiellement pédiatrique, bien qu’il y ait eu des cas de comorbidité avec la dépression et la maladie de Lyme chez les adultes. Le syndrome est associé à des infections, traumatismes, et migraines. Les études d’imagerie ont découvert des zones d’hypo-perfusion dans certaines parties du cerveau pendant les épisodes d’AIWS ; ces zones comprennent principalement le lobe occipital, mais il existe aussi des rapports d’hypo-perfusion frontale et temporale. Ceci est un syndrome neuropsychiatrique rare et intéressant qui présente avec des hallucinations visuelles uniques. Dans la population pédiatrique, il peut être un signe d’infection virale non diagnostiquée qui justifie des tests supplémentaires.

Article Details

Issue
Vol. 5 No. 2 (2015): Neuroscience and Mental Health
Section
Review & Clinical Practice
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Author Biography

Adrienne Harrison, McMaster University

McMaster University - Psychology, Neuroscience & Behaviour

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