Alice-in-Wonderland Syndrome. A case report

Abstract

8 years-old girl, who requested a medical consultation because she was having visual hallucinations, started after fever and nightmares. She was being treated previously with methylphenidate for Attention Deficit and Hyperactivity Disorder. She referred having macropsias for all objects (mostly faces), and absence of dysmorphias, micropsias, or delusions. The reality judgment was normal. Owing to the suspect of infectious etiology, serology were requested, as well as MRI, EEG, evoked potentials, etc. which resulted all normal. It was prescribed melatonin, and decrease in dose of methylphenidate, leading to its cessation; however, the macropsias persisted. After 6 months of evolution, the clinical manifestations receded spontaneously. We kept infectious mononucleosis as the main etiology. We have made a bibliographical review about Alice in Wonderland Syndrome, compatible with the girl’s pathology, and the possible relation of methylphenidate with these hallucinations and other neuropsychiatric manifestations.