Tangential tractional force on the retina asserted by an ERM leads to distortion of normal retinal structure and layers, causing symptoms such as impairment of central vision, metamorphopsia, macropsia
, and monocular diplopia [1, 2].
In these cases, the sensory impairment (Syndrome of Alice in Wonderland) is an episodic syndrome characterized by a smaller (micropsia) or greater (macropsia
) perception disorder of the patient's own body or surroundings.
In order to collect data for pathophysiological sections, we consulted PubMed indexed articles using "macropsia
", "micropsia", "macrosomatognosia", "microsomatognosia", etc., even if the term Alice in Wonderland Syndrome was not expressly used.
Partial seizures arising from the temporal or frontal cortex may cause alterations in hearing, olfaction like unusual odours or psychic symptoms like sense of impending change, detachment, depersonalization, dejavu or illusions like micropsia or macropsia
. Complex partial seizures are accompanied by a transient impairment of consciousness and recovery occurs within seconds to an hour.
Table 1: Change in symptoms with Clonazepam DSM IV/V Symptom Prior to 3 months after Checklist treatment with initiation of Clonazepam Clonazepam treatment Geometric Present Absent hallucinations False perception of Present Absent movement in peripheral fields Flashes of colour Present Absent Intensified colours Present Absent Trails of images of Present Absent moving objects Positive after Present Absent images Halos around Present Present but reduced objects in intensity and frequency Macropsia
Present Absent Micropsia Present Absent
Objects can be described as distorted and eventually changed in size (macropsia
or micropsia), shape (metamorphopsia), illumination, colour, or clarity.
* the macropsia
to be seen in temporal lobe seizures, in The Sphinx: