Abstract
Abstract
Background
Macrosomatognosiais the illusory sensation of a substantially enlarged body part. This disorder of the body schema, also called “Alice in wonderland syndrome” is still poorly understood and requires careful documentation and analysis of cases. The patient presented here is unique owing to his unusual macrosomatognosia phenomenology, but also given the unreported localization of his most significant lesion in the right thalamus that allowed consistent anatomo-clinical analysis.
Case presentation
This 45-years old man presented mainly with long-lasting and quasi-delusional macrosomatognosia associated to sensory deficits, both involving the left upper-body, in the context of a right thalamic ischemic lesion most presumably located in the ventral posterolateral nucleus. Fine-grained probabilistic and deterministic tractography revealed the most eloquent targets of the lesion projections to be the ipsilateral precuneus, superior parietal lobule,but also the right primary somatosensory cortex and, to a lesser extent, the right primary motor cortex. Under stationary neurorehabilitation, the patient slowly improved his symptoms and could be discharged back home and, later on, partially return to work.
Conclusion
We discuss deficient neural processing and integration of sensory inputs within the right ventral posterolateral nucleus lesion as possible mechanisms underlying macrosomatognosia in light of observed anatomo-clinical correlations. On the other hand, difficulty to classify this unique constellation of Alice in wonderland syndrome calls for an alternative taxonomy of cognitive and psychic aspects of illusory body-size perceptions.
Publisher
Springer Science and Business Media LLC
Subject
Neurology (clinical),General Medicine
Reference20 articles.
1. Dieguez S, Blanke O. Altered states of bodily consciousness. In: Cardeña E, Winkelman, editors. Altering consciousness: a multidisciplinary perspective. Volume 2. Westport: Praeger; 2011. pp. 237–62.
2. Frederiks J. Macrosomatognosia and microsomatognosia. Psychiatr Neurol Neurochir. 1963;66:531–6.
3. Blom J. Alice in wonderland syndrome, a systematic review. Neurology. 2016;6:259–70.
4. Mastria G, Mancini V, Vigano A, Di Piero V. Alice in wonderland syndrome: a clinical and pathophysiological review. Biomed Res Int. 2016.
https://doi.org/10.1155/2016/8243145
.
5. Vallar G, Rode G. Commentary on Bonnier P. L'aschématie Rev Neurol (Paris) 1905; 13:605-9. Epilepsy Behav. 2009;16:397–400.
Cited by
5 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献