Micropsia is one of the forms of distortion of visual perception of objects in the external environment and one’s own body, in which everything around seems smaller than it really is. Sometimes this disorder is called “Alice through the Looking Glass syndrome.” This disorder is not often encountered in neurological and psychiatric practice, but it can significantly limit a person’s daily activity. Moreover, he is worried not only about the micropsia itself, which can appear suddenly and disappear just as abruptly, but he is afraid of a second attack. Medical doctors will conduct a thorough examination of the patient, find out the cause of the disorder, prescribe appropriate treatment or refer you to a specialized specialist.
Micropsia: general description
The visual organ system is one of the most complex structures of our body. Although its anatomical structure has been studied in sufficient detail, the neurological and physiological mechanisms of processing information perceived by the eye are still completely unknown.
Everything we see around us is projected in the form of light rays onto the retina, the back wall of the eye. The rods and cones located in it transform them into electrical impulses, which are transmitted to the fibers of the optic nerve.
Interesting fact! The optic nerve contains about 1 million fibers, each connecting to approximately 140–150 rods and cones.
From the retina, the impulse enters the brain, or more precisely, to the visual cortex, which in humans (as, by the way, in other mammals) is located in the occipital region. Brain neurons “process” the received signals, and as a result, we perceive the surrounding reality as a holistic picture, and act in accordance with what we see.
With micropsia, a person does not perceive the real size of the objects around him. Unlike other vision pathologies (farsightedness, myopia, etc.), illusions and hallucinations are not distorted in their outlines, shape, and the general characteristics of the perceived information do not change (for example, with hallucinosis, it seems to the patient that things are coming to life, someone is in a closet, under the table, etc.).
What causes seizures
The study of the problem of how the syndrome arises continues. It is generally accepted that the underlying migraine develops due to the deregulation of tone experienced by the vessels of the brain. Alternate states of hypoxia/hyperoxia occur, caused by the slow dilation of blood vessels that occurs after a painful sharp spasm. Disruption of neuronal activity causes hallucinations.
With the development of a migraine aura, areas of the parietal cortex of the brain are affected, usually the visual and somatosensory areas. In this case, the mechanism that integrates incoming sensory data is disrupted, and sensory and tactile sensations are distorted.
Micropsia: possible causes
Some experts suggest that this disorder may be caused by diseases of the organ of vision (paralysis of accommodation, retinal lesions, etc.). However, most doctors agree that micropsia is closely related to pathological changes in the visual cortex and dysfunction of the so-called detector neurons, which are “responsible” for recognizing visual impulses received from the retina.
The most common causes of micropsia include:
- epilepsy, and in children such visual distortions may be the only symptom of the disease; in adults, impaired perception is usually one of the manifestations of the aura preceding an attack;
- organic brain damage due to congenital anomalies, complications during childbirth;
- malignant tumors, benign and vascular neoplasms;
- migraine;
- previous ischemic or hemorrhagic stroke;
- severe traumatic brain injuries;
- complicated neuroinfections;
- brain surgery.
But sometimes micropsia is a consequence of various mental disorders, and the patient may not realize that his vision is distorted, and, accordingly, does not tell either his relatives or the doctor about it. Another cause of the syndrome is the use of drugs that belong to the class of hallucinogens.
First descriptions of the disease
After the publication of L. Carroll's mysterious fairy tale, interest in which does not fade, almost a century passed before the first description of the syndrome appeared. It belongs to Lippman. In 1952, he suggested that the disease manifests itself if there is a predisposition to migraine. Three years later, John Todd published a study in which not only was the first detailed description of the symptoms of the disease. John Todd also pioneered the work of figuring out why the syndrome occurs in children.
The psychiatrist noticed that his child patients suffering from migraines tend to have a distorted perception of size during attacks. The surrounding things and parts of the body appeared to them in an exaggerated form (in other cases, it was not metamorphopsia that occurred, but micropsia, the perception of objects as exaggerated). The Todd syndrome described by the psychiatrist shows a connection between metamorphopsia and migraine.
Clinical picture
In neurological pathologies, micropsia is unpredictable. Only with epilepsy in a child or adult or migraine can one predict an impending attack.
In mental disorders, a similar syndrome is accompanied by a number of other specific symptoms. This:
- episodes of depersonalization and derealization: the patient sees himself as if from the outside, an image of a giant appears surrounded by familiar but small objects;
- disturbances of consciousness, when the patient has difficulty perceiving, analyzing and reacting to what is happening;
- accompanying illusions: sometimes micropsia is accompanied by visual, auditory and tactile hallucinations;
- the formation of delusional ideas, and visual impairment clearly “fits” into the structure of the delusion;
- anxiety, restlessness, fixation on certain aspects of professional or everyday life, one’s own health, episodes of panic attacks are not excluded;
- depressive state.
If the pathology is associated with damage to the central nervous system, the following are typical:
- frequent severe headaches;
- memory impairment;
- decrease in cognitive abilities, intelligence;
- seizures;
- deterioration of acuity, “loss” of certain areas from the field of view (outside episodes of micropsia).
In rare cases, a combination of neurological and mental pathologies is possible.
Alice syndrome is not fun, it's dangerous
Through the Looking Glass syndrome, as a form of AIWS syndrome, may be:
- a separate disease;
- one of the symptoms of developing migraine;
- a sign of drug addiction;
- serious mental pathologies, epilepsy, brain tumors.
This mental disorder is dangerous when there are problems with the perception of the environment, when a person cannot distinguish reality from the world transformed by his psyche.
In addition to visual and auditory distortions, there is a loss of orientation in space and time. The lack of real guidelines aggravates the pathology, destroying the patient’s psyche.
Unable to assess the dimensions of objects, their distance, the patient is exposed to danger while on the street, where he loses support under his feet and is not aware of the approach of transport, other people, holes and any obstacles. He is not able to analyze the situation, assess the situation and take action, as a healthy person would do.
Cost of services
| CONSULTATIONS OF SPECIALISTS | |
| Initial consultation with a psychiatrist (60 min.) | 6,000 rub. |
| Repeated consultation | 5,000 rub. |
| Consultation with a psychiatrist-narcologist (60 min.) | 5,000 rub. |
| Consultation with a psychologist | 3,500 rub. |
| Consultation with Gromova E.V. (50 minutes) | 12,000 rub. |
| PSYCHOTHERAPY | |
| Psychotherapy (session) | 7,000 rub. |
| Psychotherapy (5 sessions) | 30,000 rub. |
| Psychotherapy (10 sessions) | 60,000 rub. |
| Group psychotherapy (3-7 people) | 3,500 rub. |
| Psychotherapy session with E.V. Gromova (50 minutes) | 12,000 rub. |
| TREATMENT IN A HOSPITAL | |
| Ward for 4 persons | 10,000 rub./day |
| Ward for 3 persons | 13,000 rub./day |
| Ward 1 bed VIP | 23,000 rub./day |
| Individual post | 5,000 rub. |
| PETE | 15,000 rub./day |
This list does not contain all prices for services provided by our clinic. The full price list can be found on the “Prices” , or by calling: 8(969)060-93-93. Initial consultation is FREE!
Specifics of pediatric micropsy
The most obvious sign of this disorder is distortion of surrounding objects. Everything around you may seem small or like a toy. In most cases, there is a feeling that all objects are located quite far away. A person himself can feel like a huge giant in a cramped room. As a rule, this phenomenon is accompanied by disorders of auditory, tactile, taste and other types of perception.
Alice in Wonderland syndrome
When such an attack occurs, a person may become upset, panic, and fear. It is sometimes difficult for him to distinguish between reality and hallucinations. If micropsia persist for a long period of time, then it becomes quite difficult for the patient to engage in usual activities, go to work and communicate with their loved ones.
Young children often treat the disease with humor. Objects that change shape and size arouse their interest. If the attacks do not last long, the child may not experience much discomfort due to problems with visual perception. As the patient grows older, he begins to feel how Lilliputian vision interferes with orientation in space. But more often with age, attacks become shorter and occur less frequently.
Stages and forms
An attack accompanied by a distortion of reality occurs in several stages.
The initial stage is characterized by the appearance of a headache or general anxiety with a gradual or sudden increase in symptoms.
The main stage is accompanied by the most severe manifestations of pathology.
At the final stage, the severity of symptoms decreases, patients experience fatigue, apathy, and drowsiness.
The duration of the attack is very variable - from a few seconds to a couple of weeks.
Depending on the clinical manifestations, Alice in Wonderland syndrome is divided into several types:
- macropsia, accompanied by a sudden strong apparent increase in surrounding objects and distances;
- micropsia, characterized by an apparent decrease in everything that surrounds a person.
Symptoms of macular degeneration:
- Blurred or weakened central vision, which is often not immediately detected because the person tends to subconsciously ignore the deterioration of vision.
- Blind spots in the central visual field, for example, individual letters or fragments of letters falling out when reading.
- Straight lines appear jagged or curved. Unusual colors or shapes appear on visible objects.
- Objects appear smaller with one eye than the other (so-called micropsia).
Causes of the syndrome
Mostly children under 12 years old suffer from this problem. With age, attacks are quite rare, and by the age of 30 they disappear completely. The child quite often experiences temporary micropsia, and they occur mainly in the evening with the onset of darkness. It was not possible to reliably determine the cause of this disease.
The most common factors include:
- Infectious mononucleosis is a disease caused by the Epstein-Barr virus.
- Malignant or benign brain tumors that compress or irritate the occipital lobe.
- Use of a variety of psychedelics, narcotic or hallucinogenic substances.
- Epilepsy, migraine, schizophrenia and other common mental and neurological disorders.
