Abstract
Alice in Wonderland Syndrome (AIWS) is a perceptual disorder, principally involving visual and somesthetic integration, firstly reported by Todd, on the literary suggestion of the strange experiences described by Lewis Carroll in Alice in Wonderland books. Symptoms may comprise among others aschematia and dysmetropsia. This syndrome has many different etiologies; however EBV infection is the most common cause in children, while migraine affects more commonly adults. Many data support a strict relationship between migraine and AIWS, which could be considered in many patients as an aura or a migraine equivalent, particularly in children. Nevertheless, AIWS seems to have anatomical correlates. According to neuroimaging, temporoparietal-occipital carrefour (TPO-C) is a key region for developing many of AIWS symptoms. The final part of this review aims to find the relationship between AIWS symptoms, presenting a pathophysiological model. In brief, AIWS symptoms depend on an alteration of TPO-C where visual-spatial and somatosensory information are integrated. Alterations in these brain regions may cause the cooccurrence of dysmetropsia and disorders of body schema. In our opinion, the association of other symptoms reported in literature could vary depending on different etiologies and the lack of clear diagnostic criteria.
Highlights
Alice in Wonderland Syndrome (AIWS) is a rare perceptual disorder, affecting the integration mechanisms among sensory associative cortices that are involved in the development of internal-external relationship
The male/female ratio seems to vary with the age: while in younger age male are predominantly affected with 2.69fold risk of having AIWS [9], no significant differences in sex prevalence were recorded in junior students (13–15 years old) by Abe et al [10], while females were significantly more prevalent (56.7%) among senior students (16–18 years)
We acknowledge that clinical presentation of AIWS may be complex and may vary according to the different pathophysiological mechanisms
Summary
Alice in Wonderland Syndrome (AIWS) is a rare perceptual disorder, affecting the integration mechanisms among sensory associative cortices that are involved in the development of internal-external relationship. AIWS remains a poorly known and probably misdiagnosed syndrome. This variableness in the diagnostic process is due to the fact that no univocally accepted diagnostic criteria for this disease have been made. AIWS can occur at any age but mostly in children and it is not solely related to one medical condition but rather can have several causes. A link with migraine seems to be suggested by the high frequency of cooccurrence of the two diseases
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
