Man's Undetected Tumor Triggers Alice In Wonderland Syndrome

John Tenniel's classic illustration 'A Mad Tea Party' for Lewis Carroll's Alice's Adventures In Wonderland. Wikimedia Commons

Anyone who has read Charles Dodgson's Alice's Adventures In Wonderland (written under his pen name Lewis Carroll), or watched Disney's cinematic retelling, will be familiar with the mind-bendingly trippy world Carroll's titular character finds herself in after she falls down the rabbit hole.

People who develop a rare condition known as Alice in Wonderland syndrome (AIWS) fall down their own rabbit hole with similarly bizarre results. One such patient is a 54-year-old man recently described in a case report published in the journal Neurocase. Symptoms started one morning as he was gazing at his computer screen. As he recalls, the desktop icons leaped out from the monitor.

The icons proceeded to float in the space between him and the screen for 10 minutes or so, moving nearer and further away before disappearing past his right side. This was followed by an hour of sensory aphasia (when the ability to understand spoken or written speech is blocked) and an intense pulsating headache. 

Visual illusions or hallucinations like these are a classic symptom of AIWS. As well as teleopsia and pelopsia (objects and people appearing further or nearer), patients may experience macropsia and micropsia (objects and people appearing bigger or smaller) and macrosomatognosia and microsomatognosia (all or some of their body appearing bigger or smaller). Think of the "eat me" cake and "drink me" vials in Alice's Wonderland and you get the idea. 

But that's not all. Straight lines may appear wavy. Inanimate objects may appear to move. Three-dimensional objects may appear to flatten. Faces may appear distorted and colors may appear to brighten – or change completely. Patients may also report feelings of derealization (your surroundings are unreal), depersonalization (your thoughts and feelings are unreal), or somatopsychic duality (you are two people at the same time). It's all very trippy.

This is because AIWS involves changes to areas in the brain involved in sensory information. But while medics suspect it is a type of migraine aura, in the same family of symptoms as the flashy lights you sometimes get before a particularly intense headache, they are not entirely sure what triggers some people to experience such psychedelic affections.

The syndrome has been linked to epilepsy, infections (the Epstein-Barr virus, for example), stroke, and schizophrenia. But in this case, it was sparked by a glioblastoma in the left temporal-occipital junction, making it the very first documented example of AIWS to be caused by cancer. Needless to say, if you experience any of these symptoms, visit your doctor immediately. 

As for the man, he had an operation to remove the tumor followed by chemotherapy and radiation treatments. The cancer did come back and required a second operation but now, 20 months after he first experienced symptoms, he appears to be doing well with no evidence of glioblastoma, doctors say.

[H/T: Live Science]

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