| Identifier |
Alice_in_wonderland_syndrome_1080p |
| Title |
Alice in Wonderland Syndrome |
| Creator |
Andrew G. Lee, MD; Nasim Khalfe |
| Affiliation |
(AGL) Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Professor of Ophthalmology, Weill Cornell Medicine, New York City, New York; (NK) Class of 2023, Baylor College of Medicine, Houston, Texas |
| Subject |
Micropsia; Macropsia; Metamorphopsia; Akinetopsia; Hallucination; Depersonalization-Derealization |
| Description |
Dr. Lee lectures medical students on the subject of Alice in wonderland syndrome. |
| Transcript |
Today we're going to be talking about Alice in Wonderland, and if you've ever read that book or watched the movie of Lewis Carroll's classic-Alice is a young girl and she basically goes to a Wonderland. She goes down the rabbit hole. She has a bunch of weird experiences, and Alice's experiences are a change in sensory perception. So it's different than hallucinations where you're seeing something that isn't there or an illusion where you seeing something that is there, but it has areal stimulus. In Alice's version, she is actually perceiving the world in a different way. And so if you read the book, you'll see she gets really really small and then she gets really really big. And so those words in doctor talk for ophthalmology, are micropsia and macropsia, things can look small or things can look big. Or they can look distorted, this is metamorphopsia. And normally those are retinal findings when they're unilateral, but when their bilateral, simultaneous and occur throughout your entire field -instead of thinking retina you should really bethinking about cerebral metamorphopsia and cerebral macropsia and cerebral micropsia. So when its bilateral simultaneous and diffuse, that's a sensory perception change. Patients can report things that's looking longer than they should be or slowing down in time, things seems to be slow or fast. Some patients report they can't even see motion - Akinetopsia - it's like a slow-motion movie or things that are frozen in time. And some patients claim that they see nose depth perception, so they might say everything looks two-dimensional even though they know it's three-dimensional. Everything looks flat to them. So that kind of sensory perception change is not really a hallucination. Again, the same requirements as for all hallucinations that are cortical in nature, you need todo an MRI scan to make sure there's no structural lesion and we're going to do an EEG. But the most common cause of the Alice in Wonderland phenomenon is migraine. Obviously, there's no tests to prove it's migraine, but migraine is a very very common cause of these sense perception deficits. Things look too small, things look too big, things look flat in 2D or 3D.There's a differential diagnosis for the Alice in Wonderland syndrome, however, in addition to seizure, structure lesions and migraine. Whole host of structural things have been associated with this, but there are DSM-5 diagnosis that have been associated with the Alice in Wonderland phenomenon. And so we need to ask about the DSM-5 types of things that could be a part of this. In contrast to the DSM-5 diagnosis that have hallucinations where the patients don't have insight into the problem, those DSM-5 types of diagnoses are different than the ones that have insight. And one of the ones I want to leave you with is depersonalization-derealization syndrome. So in the derealization syndrome, the patients feel disconnected from reality. So they have the experience, everything looks 2D and flat or everything slowed down in time, but they don't feel they're actually there. And they often have a very difficult time describing this sensation of derealization. The reality isn't real, and that is what Alice in Wonderland is about. She goes into an alternate reality. The sensations and the sensory things that she experiences are real but she doesn't feel that it's real she's disconnected from it. When she returns to the real world, our world, she can still remember and she has full insight into those phenomenon. And that DSM-5 diagnosis is derealization-depersonalization syndrome. |
| Date |
2021-06 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Andrew G. Lee Collection: https://novel.utah.edu/Lee/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5890 |
| Rights Management |
Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6x98b05 |
| Setname |
ehsl_novel_lee |
| ID |
1701553 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6x98b05 |
