Treatment of Alice in Wonderland Syndrome

GP: to inform

SP: to inform my audience about what Alice in Wonderland syndrome is and its origins, the symptoms that patients with AIWS experience, and the treatment options available if applicable.

CI: In most fantasy filled films, the movie-goers usually do not expect that of real life experiences to become a reality much like Alice in Wonderland syndrome where there it has its roots from its upbringing, the symptoms associated with the disease, as well as treatment that patients may try.

Introduction:

(Attention Getter)

Dr. Seuss once said, I like nonsense, it wakes up the brain cells. Fantasy is a necessary ingredient in living, it's a way of looking at life through the wrong end of a telescope. Which is what I do, and that enables you to laugh at life's realities.

(Relate topic to audience)

Much like the way different movie genres play in our heads as we watch them, we wouldnt usually expect experiences in an animation to be a reality. Everyone has seen Alice in Wonderland at least once in their life, and crazily enough, all the weird perceptions and situations Alice goes through can be found in people around, whether thats a friend or a stranger to you.

(Credibility)

Im personally majoring in the field of neuropsychology so I can offer some knowledge about how this disorder ultimately affects the brain.

(CI)

In order to really know what Alice in Wonderland syndrome is, youll first be taken to the origins of its presence, then be informed about the symptoms that can be found of those suffering from AIWS, and lastly figuring out treatment options suitable for these patients.

Body:

From the first time the acronym AIWS was used to merely describe illusions seen by the perceptual eye, it evolved to diagnosing patients who have abnormal cerebral perfusion.

English psychiatrist John Todd was the first to use this term.

Todd used the term in association with the body distortions and image illusion that children who suffered from migraines and epilepsy were seeing due to their condition.

Alice from Lewis Carrolls Alice in Wonderland novel inspired the application of the disorder name to describe her hallucinated episodes.

B. Alice in Wonderland syndrome is defined as a neurological condition consisting of disorientating episodes mostly found in children and adults around the ages of fifty and sixty.

1. British neurologist William Gowers in 1907 reported that children with seizures experience, feelings of unreality in what is seen.

2. A majority of patients with this syndrome often have a family history of migraine headache or have overt migraine themselves.

Transition: Now that you are informed on the basis of what AIWS is, I will lay out the common symptoms of this disorder.

II. According to Biomedical Central in a case report written in 2017 by Yokoyama and his colleagues, they describe three symptoms that patients reported over the years that correlate to Alice in Wonderland syndrome.

The first symptom is extrapersonal visual image (micropsia, macropsia, teleopsia)

People may see things such as objects or people being smaller (micropsia), larger/taller (macropsia), and further away than they actually are (teleopsia).

In the case report done by Yokoyama and his colleagues, they studied a 63 year old Japanese man whose surroundings were extremely small in his perception. He gave up driving due to disruption in his sense of distance and speed as the cars around him looked way too small.

Another symptom of this disease is an altered perception of ones body image.

Individuals will feel as though their bodies have been altered in size and will have visual perceptions.

People may have intense and explicit hallucinations such as seeing objects that everyone else around them cannot see and misinterpreting their own perceptions.

The last symptom reported is a disturbed sense of the passage of distance and time.

Illusionary movement is very common with this symptom, patients experience a distortion of time perception with either the time moving too fast or too slow.

The same elderly man in the case report admitted to feeling as though he could surpass great distances even with the knowledge that it couldnt be possible. He felt as if he could reach the center of Tokyo from his home in a blink of an eye despite the 31 mile distance from both places.

Transition: Last, but not least we are going to explore the treatment options.

Body:

III. Unfortunately, there is no array of options in terms of treatment. According to a case report written in 2011 by Blom and colleagues on the fMRI findings for the treatment of AIWS, repetitive transcranial magnetic stimulation is the main source of treatment for patients.

In the case report they found that those with the symptoms of AIWS usually connected to having verbal auditory hallucinations and are early signs of a viral infection.

The relationship between Alice and Wonderland syndrome and those also experiencing verbal auditory hallucinations have led researchers to turn to transcranial magnetic stimulations for complete remission of symptoms.

An fMRI is conducted in order to localize cerebral activity in the left and right gyri and the prefrontal cortex. From there, they used the fMRI to activate certain parts of the brain so remission was successful.

A 36 year old woman was the patient of Blom and his colleagues in this case report to test the treatment. They found that while the TMS treatments worked to lessen her sensory distortions and perceptions they were able to conclude that these stimulation treatments have therapeutic effects on the symptoms of those suffering from AIWS.

B. In other cases (clinical) where some patients did not experience having verbal auditory hallucinations, they were often prescribed antiepileptic drugs, antibiotics, antiviral drugs, and painkillers.

When there are underlying issues such as migraines and epilepsy, individuals are further assessed and are later prescribed to different drugs.

With the drug prescription for these patients, there is no guaranteed induction or aggravation of the drugs in ones system.

Transition: In short, although this disorder is not commonly known, it justifies itself as being equally important to any other familiarized disorder in the community.

Conclusion

(Recap main points/thesis)

I. Alice in Wonderland syndrome can be dated back as far as the early 1900s where it was first used.

II. There are three symptoms most frequently found in patients who have AIWS.

III. Treatment is available but differs in many different cases.

(Conclude with a memorable and creative thought): Illness and art have a relationship to them that we have yet to realize sometimes, the next time you think something is just mere fantasy, you might think twice about it being somebody elses reality.

References

Alice in Wonderland Syndrome. (2016, June 15). Retrieved June 12 2018, from https://www.medicalbag.com/profile-in-rare-diseases/alice-in-wonderland-syndrome/article/472825/

Blom, J. D., Looijestijn, J., Goekoop, R., Diederen, K. M. J., Rijkaart, A., Slotema, C. W., & Sommer, I. E. C. (2011). Treatment of alice in wonderland syndrome and verbal auditory hallucinations using repetitive transcranial magnetic stimulation: A case report with fMRI findings. Psychopathology, 44(5), 337-44. https://ezproxy.canyons.edu:2069/10.1159/000325102 Retrieved from https://ezproxy.canyons.edu:2048/login?url=https://ezproxy.canyons.edu:2457/docview/883071540?accountid=38295

Brumm, K., Walenski, M., Haist, F., Robbins, S. L., Granet, D. B., & Love, T. (2010, August). Retrieved June 12, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928409/

Fine, Edward, et al. Alice in Wonderland Syndrome:A History (P6.337). Neurology, Wolters Kluwer Health, Inc. on Behalf of the American Academy of Neurology, 6 Apr. 2015, n.neurology.org/content/84/14_Supplement/P6.337.

Yokoyama, T., Okamura, T., Takahashi, M., Momose, T., & Kondo, S. (2017, April 27). A case of recurrent depressive disorder presenting with Alice in Wonderland syndrome: psychopathology and pre- and post-treatment FDG-PET findings. Retrieved June 12, 2018, from https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1314-2

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