Neurophysiology of a double aura in migraine and Alice in wonderland syndrome: Is there a link?

Abstract

ObjectivesAlice in Wonderland syndrome (AIWS) is a pathological condition characterized by distortions of visual representation, with symptoms deforming images, figures, bodies, objects, which are seen larger or smaller than normal. Causes are sought in infectious diseases, psychiatric illness, migraines. It may be associated with alterations in the body schema such as non-recognition of own body in space. It's a rare form of visual aura. Unlike it, migraine with aura is a very frequent disorder, in which the phenomenon of visual aura is considered a consequence of cortical spreading depression(CSD), a wave of depolarization that propagates from the occipital cortex, creating a vasoconstriction and visual disturbances. MethodsRecent studies have found an anatomical correlation between visual and somatosensory disorders such as those found in AIWS, located in the temporo- parieto-occipital junction.Neuroimaging studies allowed to identify the CSD and the occipital cortex responsible for the mechanism of the visual aura and the involvement of the parietal cortex in the genesis of the somatosensory aura. ResultsThe mechanism of the initiation of the stage of visual and somatosensory aura could be a combination of two events. ConclusionsLiterature data now offer agreed confirmations on the role of the CSD associated to somatosensory aura.