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A Journal on Internal Medicine

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Minerva Medica 1999 October;90(10):397-404

language: Italian

'Alice in Wonderland syndrome'

Cau C.


The ''Alice in Wonderland syndrome includes an array of symptoms involving altered perception of shape (meta-morphopsia) of objects or persons who appear to be smaller (micropsia) or larger (macropsia) than normal, of impaired sense of passage of time, of zooming of the enviroment. This unusual neurological picture which can be confused with psychosis or drug intoxication has been found to accompany cerebral lesions mainly temporo-occipital or parietal-occipital temporal epilepsy and migraine. Todd gave the syndrome its literary name in his report in 1955, describing a singular group of symptoms closely associated with migraine and epilepsy. However the first description of the condition was made by Lippman in 1952. This syndrome is so called because of the resemblance of its symptoms to the fluctuations in size and shape that plague the main character in Lewis Carrol's 1865 novel Alice in Wonderland. Cases of ''Alice in Wonderland'' syndrome have been described associated with infectious mononucleosis. In each clinical case, the classical infectious mononucleosis symptoms and diagnosis followed the onset of visual aberration. Nuclear medicine techniques are able to demonstrate changes in cerebral perfusion and may be used to detect abnormal cerebral areas in patients with AIWS.

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