The Mental Health Syndrome Known as Alice in Wonderland - A Case Report

Jennings Hernandez *

Washington University of Health and Science, United States of America.

*Author to whom correspondence should be addressed.


The Alice in Wonderland Syndrome (AIWS) is a rare neurological and psychiatric condition, represented as the appearance of disorienting perceptual disorder with occasional episodes of bizarre visual illusions and spatial distortions. It was first introduced by John Todd in 1955, based on the literary chronicles of the strange encounters described by Lewis Carroll in Alice in Wonderland books. A 30-year-old healthy male presented to the doctor’s office with left-sided headaches lasting 24 hours and preceded by an aura. During these auras, the patient was experiencing erratic behaviors consistent with the phenomena experienced by Alice, the main character in the world-famous story. He reported objects being larger and further away than they really were and his hands appearing smaller than they really were. Symptoms lasted up to 45 minutes. All clinical and diagnostic workups and evaluations were unremarkable, and the patient was treated for migraines with auras using Valproic Acid. During his follow-up at 3 months intervals, the patient continued with symptoms, and his medication dosage was increased. In his next follow-up three months later, he described having no more symptoms. AIWS has been found to be related to migraines with preceding auras.  It is both common in pediatrics as well as in adults. I present an AIWS case co-existent with aura migraines.

Keywords: Alice in wonderland syndrome, metamorphopsias, Todd’s Syndrome, lilliputian hallucinations, macropsia, micropsia, teleopsia, pelopsia, aschematia, dysmetropsia, migraines, aura

How to Cite

Hernandez, J. (2022). The Mental Health Syndrome Known as Alice in Wonderland - A Case Report. International Neuropsychiatric Disease Journal, 18(1), 43–47.


Fine Edward, Farooq O, Mahfooz N. Alice In Wonderland Syndrome: A History (P2.042). American Academy of Neurology; 2017.


Mastria G, Mancini V, Vigano A, Di Piero V. Alice in Wonderland Syndrome: A Clinical and Pathophysiological Review. The Journal of NIH Research; 2016.


Shah A, Magaña S, Youssef P. Do You See What I See? A Case of Alice in Wonderland Syndrome with EEG Correlates. Sage Journals; 2020.


Buyukgol H, Gunes E. Alice in Wonderland Syndrome: A Case Report. Journal of Neuroscience and Neuropsychology; 2018.


Palacios-Sanchez L, Botero-Meneses J, Mora-Munoz L, Guerrero-Naranjo A, Moreno-Matson M, Pachon N, Charry-Sanchez J. Alice in Wonderland Syndrome (AIWS): A Reflection. Colombian Journal of Anesthesiology; 2018.


Kikkeri N, Nagalli S. Migraine with Aura. The Journal of NIH Research; 2022.


De Boer I, Van Den Maagdenberg A, Terwindt G. Advance in Genetics of Migraine. Current Opinion in Neurology Journal. 2019.


Goadsby P, Holland P, Martins-Oliveira M, Hoffman J, Schankin C, Akerman S. Pathophysiology of Migraine: A Disorder of Sensory Processing. The Journal of NIH Research; 2017.


Bloom J. Alice in Wonderland Syndrome. The Journal of NIH Research; 2016.


Ilik F, Ilik K. Alice in Wonderland Syndrome as Aura of Migraine. The Journal of NIH Research. 2014.


Evans R, Lipton R. Topics in Migraine Management: A Survey of Headache Specialists Highlights Some Controversies. Elsevier Journal; 2001.


Tunc S, Basbug H. Alice in Wonderland Syndrome: A Strange Visual Perceptual Disturbance. Journal of Psychiatry and Clinical Pharmacology; 2017.