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Additionally, distortion of time perception and symptoms of derealization\/depersonalization may occur. AIWS is frequently associated with migraine. However, its prevalence, and clinical characteristics remain poorly understood. Here, we investigated the prevalence and features of AIWS in individuals with migraine. We hypothesized AIWS is more frequent in migraine patients with aura than in those without aura.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective cross-sectional cohort study, conducted at a tertiary headache center. Participants with migraine filled out questionnaires, providing details on demographics, headache, AIWS characteristics and the occurrence of transient visual phenomena such as fragmented vision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 808 migraine patients, 133 individuals (16.5%, mean age 44.4\u2009\u00b1\u200913.3\u00a0years, 87% women) reported AIWS symptoms throughout their lives. Micro- and\/or telopsia (72.9%) were most frequent, followed by micro- and\/or macrosomatognosia (49.6%), and macro- and\/or pelopsia (38.3%), lasting on average half an hour. AIWS symptoms occurred in association with headache in 65.1% of individuals, and 53.7% had their first AIWS episode at the age of 18\u00a0years or earlier. Migraine patients with aura were more likely to report AIWS symptoms than those without aura (19.5% vs. 14.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Participants with AIWS reported a higher incidence of 17 out of the 22 investigated visual phenomena.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AIWS symptoms appear to be a common lifetime phenomenon in migraine patients. The correlation and clinical parallels between AIWS and migraine aura could indicate shared underlying pathomechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-024-12471-5","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T14:02:49Z","timestamp":1717164169000},"page":"5146-5155","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Alice in Wonderland Syndrome (AIWS): prevalence and characteristics in adults with migraine"],"prefix":"10.1007","volume":"271","author":[{"given":"Mira P.","family":"Fitzek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper","family":"Mecklenburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas H.","family":"Overeem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin S.","family":"Lange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Siebert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Triller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Neeb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens P.","family":"Dreier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kondziella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Reuter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9758-1494","authenticated-orcid":false,"given":"Bianca","family":"Raffaelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"12471_CR1","doi-asserted-by":"publisher","unstructured":"(2023) Abstracts from the International Headache Congress 14\u201317 September 2023. 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Financial interests: MF reports personal fees from Novartis and Teva. JM reports personal fees from Novartis. LHO has nothing to disclose. KSL reports personal fees from Teva and Acticor Biotech. AS reports personal fees from TEVA and Novartis. PT reports personal fees from AbbVie. LN reports personal fees from Abbvie, Allergan, BIAL, Lilly, Lundbeck, Hormosan, Novartis, and Teva, and research funding from Lily and Teva. JPD has nothing to disclose. UR reports personal fees from Amgen, Allergan, Abbvie, Lilly, Lundbeck, Novartis, electroCore, Medscape, StreaMedUp, and Teva, and research funding from Novartis. DK reports personal fees from Wiley, and research funding from among others the Lundbeck Foundation and the Novo Nordisk Foundation. BR reports research grants from Novartis and Lundbeck\u00a0and personal fees from Abbvie\/Allergan, Eli Lilly, Lundbeck, Novartis, Perfood\u00a0and Teva.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. The study was approved by the ethics committee of Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin (EA\/149\/20) and registered in the German Clinical Trial Registry (Deutsches Register Klinischer Studien, DRKS) with the ID DRKS00025845. Prior to participation, interested patients were asked to agree to informed consent statement. Data were kept confidential and were not disclosed unless for study purposes. This study is reported in accordance with the \u201cStrengthening the Reporting of Observational Studies in Epidemiology\u201d (STROBE) statement for cohort studies [\n                      \n                      ].","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}