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Primary care challenges of an obscure case of “Alice in Wonderland” syndrome in a patient with severe malaria in a resource-constrained setting: a case report

Overview of attention for article published in BMC Infectious Diseases, December 2017
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3 tweeters
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1 Facebook page

Citations

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3 Dimensions

Readers on

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37 Mendeley
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Title
Primary care challenges of an obscure case of “Alice in Wonderland” syndrome in a patient with severe malaria in a resource-constrained setting: a case report
Published in
BMC Infectious Diseases, December 2017
DOI 10.1186/s12879-017-2918-3
Pubmed ID
Authors

Benjamin Momo Kadia, Cyril Jabea Ekabe, Ettamba Agborndip

Abstract

"Alice in Wonderland" syndrome (AIWS) is a rare neurological abnormality characterized by distortions of visual perceptions, body schema and experience of time. AIWS has been reported in patients with various infections such as infectious mononucleosis, H1N1 influenza, Cytomegalovirus encephalitis, and typhoid encephalopathy. However, AIWS occurring in a patient with severe malaria is less familiar and could pose serious primary care challenges in a low-income context. A 9-year-old male of black African ethnicity was brought by his parents to our primary care hospital because for 2 days he had been experiencing intermittent sudden perceptions of his parents' heads and objects around him either "shrinking" or "expanding". The visual perceptions were usually brief and resolved spontaneously. One week prior to the onset of the visual problem, he had developed an intermittent high grade fever that was associated with other severe constitutional symptoms. Based on the historical and clinical data that were acquired, severe malaria was suspected and this was confirmed by hyperparasitaemia on blood film analysis. The patient was treated with quinine for 10 days. Apart from a single episode of generalized tonic-clonic seizures that was observed on the first day of treatment, the overall clinical progress was good. The visual illusions completely resolved and no further abnormalities were recorded during 3 months of follow-up. Symptoms of AIWS usually resolve spontaneously or after treatment of an underlying cause. In our case, the successful treatment of severe malaria coincided with a complete regression of AIWS whose aetiology was poorly-elucidated given the resource constraints. In any case, the good outcome of our patient aligns with previous reports on acute AIWS that highlight a limited need for excessive investigation and treatment modalities which are, in passing, predominantly unaffordable in resource-limited primary care settings.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 37 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 19%
Student > Ph. D. Student 6 16%
Student > Bachelor 6 16%
Student > Doctoral Student 6 16%
Student > Master 4 11%
Other 5 14%
Unknown 3 8%
Readers by discipline Count As %
Medicine and Dentistry 18 49%
Nursing and Health Professions 3 8%
Biochemistry, Genetics and Molecular Biology 3 8%
Veterinary Science and Veterinary Medicine 2 5%
Psychology 2 5%
Other 4 11%
Unknown 5 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 April 2018.
All research outputs
#7,718,208
of 12,799,521 outputs
Outputs from BMC Infectious Diseases
#2,377
of 4,742 outputs
Outputs of similar age
#200,891
of 385,614 outputs
Outputs of similar age from BMC Infectious Diseases
#307
of 653 outputs
Altmetric has tracked 12,799,521 research outputs across all sources so far. This one is in the 37th percentile – i.e., 37% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,742 research outputs from this source. They receive a mean Attention Score of 4.8. This one is in the 45th percentile – i.e., 45% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 385,614 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 44th percentile – i.e., 44% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 653 others from the same source and published within six weeks on either side of this one. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.