Alice-in-Wonderland syndrome - A case-based update and long-term outcome in nine children

Abstract

Purpose: There are some reports of so-called Alice-in-Wonderland syndrome mostly concerning differential diagnosis, association with a variety of infectious diseases and even some case reports on functional imaging. Long-term data are rare. Methods: Nine boys aged 6 to 11 years that had been diagnosed with Alice-in-Wonderland syndrome between 2003 and 2008 were contacted for a long-term follow-up study in summer, 2009, with a mean follow-up of 4.6 years. Results: At the time of the follow-up study, all children were in good general and mental health. Symptoms of Alice-in-Wonderland syndrome had ceased within weeks or months. In two patients, episodes of metamorphopsia returned after a symptom-free latency of 3 years and 1 year, respectively. Five children had a family history of migraine or epilepsy. In one case, the father was reported to have experienced similar symptoms when he was a child. Conclusion: Our follow-up study shows that Alice-in-Wonderland is most likely a benign, self-terminating childhood condition, although occasional recurrences of symptoms are possible. © Springer-Verlag 2011.