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

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.