小児欠神てんかん寛解後に不思議の国のアリス症候群を発症しgiant VEPを認めた一例

秋山 翔太; 大栗 聖由; 山田 博之; 斎藤 義朗; 池口 拓哉; 佐藤 研吾; 廣岡 保明; 小河 佳織; 樋本 尚志; 前垣 義弘

doi:10.11422/jscn.48.121

Case Report

Giant VEP after remission of childhood absence epilepsy in a case of Alice in Wonderland syndrome

Shota Akiyama, Masayoshi Oguri, Hiroyuki Yamada, Yoshiaki Saito, Takuya Ikeguchi, Kengo Sato, Yasuaki Hirooka, Kaoru Ogo, Takashi Himoto, Yoshihiro Maegaki

Author information

Shota Akiyama
Department of Pathological Science and Technology, School of Life Sciences, Faculty of Medicine, Tottori University
Masayoshi Oguri
Department of Pathological Science and Technology, School of Life Sciences, Faculty of Medicine, Tottori University
Department of Medical Technology, Kagawa Prefectural University of Health Sciences
Hiroyuki Yamada
Department of Child Neurology, Institute of Neurological Science, Faculty of Medicine, Tottori University
Yoshiaki Saito
Department of Child Neurology, Institute of Neurological Science, Faculty of Medicine, Tottori University
Takuya Ikeguchi
Department of Pathological Science and Technology, School of Life Sciences, Faculty of Medicine, Tottori University
Kengo Sato
Department of Pathological Science and Technology, School of Life Sciences, Faculty of Medicine, Tottori University
Yasuaki Hirooka
Department of Pathological Science and Technology, School of Life Sciences, Faculty of Medicine, Tottori University
Kaoru Ogo
Department of Medical Technology, Kagawa Prefectural University of Health Sciences
Takashi Himoto
Department of Medical Technology, Kagawa Prefectural University of Health Sciences
Yoshihiro Maegaki
Department of Child Neurology, Institute of Neurological Science, Faculty of Medicine, Tottori University

Keywords: Alice in Wonderland syndrome, visual evoked potential, VEP, SPECT

JOURNAL FREE ACCESS

2020 Volume 48 Issue 3 Pages 121-126

DOI https://doi.org/10.11422/jscn.48.121

Details

Abstract

We describe an abnormal visual evoked potential (VEP) after the remission of childhood absence epilepsy in a patient with Alice in Wonderland syndrome (AIWS). A 10-year-old girl presented with abnormal visual symptoms (micropsia and macropsia). Although the VEP latencies were normal, the VEP amplitude showed significant high amplitudes of both N75–P100 and P100–N145 on Oz–Fz. Moreover, SPECT showed low cerebral blood flow in the right parietal area. These results may have been caused by cortical hyperexcitability due to the patient’s history of epilepsy. The pathophysiology of AIWS may be easy to assess with simultaneous VEP and SPECT.

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