Inês Barreira do Couto1, Joana Monteiro1, Catarina Tavares1, Matilde Pinto2, Jorge Rodrigues1, Rui André3.
1Department of Pediatrics, Unidadade Local de Saúde Viseu Dão-Lafões, Viseu, Portugal,
2Department of Pediatrics, Centro Materno Infantil do Norte, Centro Hospitalar Universitário de Santo António, Portugal,
3Department of Neurology, Unidadade Local de Saúde Viseu Dão-Lafões, Viseu, Portugal.
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Abstract
Introduction: Alice in Wonderland Syndrome (AIWS) is a rare neurological condition that affects multisensory perception, characterized by transient disturbances in visual and somatosensory domains. Symptoms are typically paroxysmal and self-limiting but can recur. Several underlying conditions can be associated with this syndrome, including infectious and neuropsychiatric disorders. Diagnosis is clinical, after excluding other potential etiologies.
Case report: We report the case of a 9-year-old boy with a 4-year history of recurrent episodes of visual distortions accompanied by holocranial headache. Physical examination was unremarkable, and complementary investigation revealed no abnormalities. Given the absence of another underlying condition, a diagnosis of AIWS associated with migraine with aura was established and reassurance was given.
Discussion/Conclusion: Recognition of this syndrome is essential for timely diagnosis, avoidance of unnecessary investigations, and appropriate management. Treatment should address the underlying condition, although in most cases, reassuring the benign nature of the symptoms is sufficient for relief.
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