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Vol. 21 - Num. 82

Clinical Reviews

Alice in Wonderland syndrome and Epstein-Barr virus infection

Francisco Javier Vara Moratea, M.ª Concepción Soriano Gonzáleza, Francisco Javier Garriguet Lópeza, Mario Enrique Valle Alonsob

aMédico de Familia. Servicio de Urgencias del Hospital Valle del Guadiato. Peñarroya-Pueblonuevo. Córdoba. España.
bMIR-Psiquiatría. Hospital General Universitario de Elche. Elche. Alicante. España.

Correspondence: FJ Vara. E-mail:

Reference of this article: Vara Morate FJ, Soriano González MC, Garriguet López FJ, Valle Alonso ME. Alice in Wonderland syndrome and Epstein-Barr virus infection. Rev Pediatr Aten Primaria. 2019;21:e67-e70.

Published in Internet: 21-05-2019 - Visits: 37397


Infection with Epstein-Barr virus (EBV) is common and usually occurs in childhood or early adulthood. EBV is the cause of infectious mononucleosis, usually associated with fever, sore throat, swollen lymph nodes in the neck, and sometimes an enlarged spleen. Alice in Wonderland Syndrome (AIWS), also called Todd’s syndrome, is a rare condition, principally involving visual and somesthetic integration. AIWS remains a poorly known and probably misdiagnosed syndrome, can occur at any age but mostly in children is mostly associated with migraine and EBV infection. We present a 10-year-old patient who went to the emergency department with visual distortion of corporal form and bizarre behaviour, initially suspected as a psychiatric pathology but subsequently diagnosed with infectious mononucleosis and serologically confirmed Epstein-Barr virus (EBV) infection. This case reflects the importance of recognizing this syndrome by emergency physicians in order to avoid inadequate referrals to the psychiatric service.


Alice in Wonderland Syndrome Epstein-Barr virus Infectious mononucleosis Perceptional disorder



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