From dizziness to "Wonderland"

An 11-year-old girl complains of anxiety and dizziness of a few hours of evolution. After a medical history and physical examination she is diagnosed with a syndrome of “Alice in wonderland” (SAPM in Spanish), caused by a cough suppressant (dextromethorphan). The knowledge of this syndrome and its anatomical basis is essential for distinguishing it from other entities much more frequent as: vertigo, instability or light-headedness. Alterations in perception that we find in the SAPM, originate in certain areas of the parieto-temporal lobe. This makes the description difficult for the patient (they are illusions) and therefore complicates the diagnosis. Although rare, it has to be taken into account in the differential diagnosis of "dizziness".