讓世界變小或變大的病症… 真的有！----中壢英文補習班－金學堂英語的部落格

【聯合報╱By HELENE STAPINSKI╱陳世欽譯】

When the World Seems to Shrink, or Grow

My 10-year-old daughter, Paulina, had a headache right before bedtime. After a few minutes, she said, “Everything in the room looks really small.”

I suddenly remembered: When I was young, I too would sometimes see things as if they were at the wrong end of a telescope, usually when I had a fever or was nervous. The episodes could last from a few minutes to an hour, but faded as I grew older.

The condition, as I have since learned, is called Alice in Wonderland Syndrome. Episodes usually include micropsia (objects appear small) or macropsia (objects appear large). Some sufferers perceive their own body parts to be larger or smaller.

Dr. John Todd, a British psychiatrist, gave the disorder its name in a 1955 paper, noting that the misperceptions resemble Lewis Carroll’s descriptions of what happened to Alice. It’s also known as Todd’s Syndrome.

Its possible triggers are infections, migraine, stress and drugs, particularly some cough medicines. Epilepsy and stroke were sometimes linked as well, the researchers said. Some even believe that Lewis Carroll, who described his migraines in his journal, may have suffered from it.

Alice in Wonderland Syndrome is not an optical problem or a hallucination. Instead, it is most likely caused by a change in the brain’s parietal lobe, which processes perceptions of the environment. Some specialists consider it a type of aura, a sensory warning preceding a migraine. And the doctors confirmed that i t usually goes away by adulthood.

Several neurologists have done M.R.I.s on patients with the condition, though once the bout has passed, there’s usually no sign of unusual brain activity.

Dr. Sheena Aurora, a neurologist and migraine specialist at Stanford University in California, was the first to do an M.R.I. scan of the brain of someone — a 12-year-old girl — in the middle of an episode.

According to Dr. Aurora’s 2008 report, electrical activity caused abnormal blood flow in the parts of the brain that control vision and process texture, shape and size.

Dr. Grant Liu, a pediatric neuro- opthalmologist at the Children’s Hospital of Philadelphia, said his research into the syndrome shows that even small changes to the brain can yield dramatic effects. When those areas involved in determining size, shape and distance malfunction, he said, “the resulting visual experience can be extraordinary.”

Dr. Liu said 33 percent of 48 cases he studied were traced to an infection, 6 percent to migraine and another 6 percent to head trauma. Otherwise, no cause was found.

A quarter of the subjects eventually developed migraines, Dr. Liu also found.

Dr. Liu said it took time for family members of those studied to admit that they too had the syndrome, which leads him to believe that it may be more widespread than people think. Indeed, I soon discovered my 14-year-old son, Dean, had episodes for years — though he had never mentioned it .

“A lot of family members didn’t own up to it on the first go-round,” said Dr. Liu. “They were almost too embarrassed. People want to be told that they’re not crazy.”

中譯

我10歲的女兒寶琳娜某日就寢前突然頭疼。幾分鐘後，她說：「房間裡的每一件東西看來都很小。」

我突然想起來。我小時候偶爾也會覺得好像每一件東西的大小都不對，而且通常在我發燒或緊張時。這些情形可能持續幾分鐘到一個小時，並隨我年齡漸長而逐漸消失。

我此後得知，這種症狀名為「愛麗絲夢遊仙境症候群」，主要症狀通常包括視物顯小症與視物顯大症。部分患者會覺得自己身體的某一部分變大或變小。

英國精神病學家陶德在1955年發表的研究報告中為這種症狀取了前述名稱。他指出，這種錯覺符合英國作家路易斯‧卡羅對愛麗絲眼中所見景象的描述。它也稱「陶德症候群」。

可能的原因包括感染、偏頭痛、壓力與藥物，尤其是某些咳嗽藥。研究人員說，癲癇與中風有時也有關係。部分人士甚至認為，卡羅曾經在他的日記中描述自己的偏頭痛，可能也曾經面臨同樣的困擾。

「愛麗絲夢遊仙境症候群」不是視力問題或幻覺。它極可能是大腦的頂葉出現變化所引起。頂葉負責處理對周遭環境的感覺。部分專家認為，它是一種預兆，是偏頭痛出現之前的一種感覺預警。醫學界已經證實，它通常會在當事人成年後消失。

部分神經科專家曾對有這種症狀的病人做磁振造影（MRI）掃描，可是症狀消失後大腦通常不會出現活動異常的徵兆。席娜‧奧洛拉是加州史丹福大學的神經科醫師兼偏頭痛專家，是第一個對出現幻覺時的病患做大腦MRI掃描的專家，病患是個12歲的女孩。

奧洛拉在她2008年發表的報告中指出，電的活動足以使大腦一些部位血液流動異常，這些部位負責控制視覺並處理質地、形狀及大小。

費城兒童醫院小兒神經眼科專家葛蘭特‧劉表示，他對這種症狀進行研究後發現，大腦的細微變化也可能產生很大的效應。他說，一旦涉及判斷大小、形狀與距離的大腦部位機能失常，可能就會產生「十分特別的視覺經驗」。

劉醫師說，他研究的48個個案33%與感染有關，6%與偏頭痛有關，6%與頭部傷害有關。其他案例則查不到原因。

他還說，四分之一的病人最後出現偏頭痛的問題。