Alice in Wonderland Syndrome: Nighttime Urination and Visual Disturbances

Q: Alice in Wonderland Syndrome: Nighttime Urination and Visual Disturbances

Hello： In response to your message... <br>1. <br>The term "Alice in Wonderland syndrome" you mentioned refers to a sleep disorder, where the patient's EEG shows slow-wave sleep, but the individual may get up and walk around while being disoriented and having no recollection after

Alice's Adventures in Wonderland

I have a habit of waking up to urinate every night, and for the past two weeks, each time I wake up, I see a dense gray mesh pattern that resembles an army of ants.
I've heard people say this is Alice in Wonderland Syndrome.
Can you explain why this happens?

Xu, 40~49 year old female. Ask Date: 2004/11/08

Dr. Xiao Yongxun reply Internal Medicine

Hello: In response to your message...
1.
The term "Alice in Wonderland syndrome" you mentioned refers to a sleep disorder, where the patient's EEG shows slow-wave sleep, but the individual may get up and walk around while being disoriented and having no recollection afterward.
In more extreme cases, there may be violent behavior.
Generally, this condition is most common in children aged 4 to 8 years.
For differential diagnosis, it may be necessary to consider factors such as medications, epilepsy, nightmare disorders, and psychiatric conditions, among others.
2.
You are 40 years old this year, and based on your description, it is unlikely to be a sleep disorder; it may be necessary to consider issues related to internal medicine or ophthalmology.
3.
It is recommended that you first consult your family physician or make an appointment with the family medicine department at Taichung Hospital to discuss your concerns with a physician.
Department of Health, Keelung Hospital, Executive Yuan, Hsiao Yong-Hsun.

Reply Date: 2004/11/08

More Info

Alice in Wonderland Syndrome (AIWS) is a fascinating neurological condition that can cause distortions in perception, particularly in visual and spatial awareness. It is characterized by a range of symptoms, including altered body image, distorted perception of size and shape, and visual disturbances such as seeing objects as larger or smaller than they are. In your case, the experience of seeing a "dense gray mesh" resembling a swarm of ants when you wake up at night could be related to this syndrome, but it may also have other explanations.

Firstly, let's address the frequent nighttime urination (nocturia) that you mentioned. Nocturia can be caused by various factors, including fluid intake before bed, certain medications, or underlying health conditions such as diabetes, urinary tract infections, or prostate issues in men. It is essential to evaluate the reasons behind your nocturia, as it can lead to sleep disturbances and impact your overall health.

Now, regarding the visual disturbances you are experiencing upon waking, there are several potential explanations. While AIWS is one possibility, other conditions could also be responsible for your symptoms:
1. Visual Hallucinations: These can occur during the transition between sleep and wakefulness, particularly if you are waking up suddenly or if you have been in a deep sleep. The brain can sometimes misinterpret sensory information during these transitions, leading to visual distortions.

2. Sleep Disorders: Conditions such as sleep apnea can lead to fragmented sleep and may cause you to wake up feeling disoriented. If you are experiencing breathing difficulties during sleep, this could contribute to your visual disturbances upon waking.

3. Migraine Aura: If you have a history of migraines, you might be experiencing a type of aura that manifests as visual disturbances. These auras can occur without a headache and may include various visual phenomena, including patterns or shapes.

4. Retinal Issues: Given that you are seeing a "gray mesh," it is also essential to consider potential retinal issues. Conditions such as vitreous detachment or retinal tears can cause visual disturbances. It is crucial to have a comprehensive eye examination to rule out any serious eye conditions.

5. Neurological Factors: AIWS is often associated with migraines, epilepsy, or infections like Epstein-Barr virus. If you have a history of neurological issues, it may be worthwhile to consult a neurologist for further evaluation.

In conclusion, while your symptoms may align with Alice in Wonderland Syndrome, it is essential to consider other potential causes, especially given the nocturia and the nature of the visual disturbances. I recommend consulting with a healthcare professional who can conduct a thorough evaluation, including a neurological assessment and an eye examination, to determine the underlying cause of your symptoms. Additionally, addressing the nocturia may help improve your overall sleep quality and reduce the likelihood of experiencing these visual disturbances at night.

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