A study in Italy highlights the possibility of Alice in Wonderland syndrome (AIWS) developing after a SARS-CoV-2 infection in children. Two cases involving visual and auditory distortions are presented, emphasizing the importance of recognizing this condition in young patients, especially during post-infectious periods.
Mom, I saw dad’s head get bigger!' Such a statement made by a child would likely alarm that child’s parents. But the child might actually be describing symptoms of Alice in Wonderland syndrome ( AIWS ), a neurologic condition aptly named after Lewis Carroll’s famous novel. Awareness of this condition in children is important, especially because it can occur during infectious events, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
This was highlighted by an Italian study published inAuditory distortions may also occur. When such distortions are the result of age-related limitations, that is, in elderly populations, patients are generally aware that their perceptions are not real (unless the patient has a psychiatric condition such as psychosis). However, AIWS is more commonly observed in children. 'When not associated with lesions in the central nervous system, it can occur alongside infections or shortly thereafter,' explained Susanna Staccioli, MD, a pediatric neurologist at the Bambino Gesù Pediatric Hospital in Rome, Italy, and the lead author of the study, which presented two pediatric cases of AIWS linked to SARS-CoV-2 infection.The first case involved an 8-year-old girl with no prior history of migraines or epilepsy. She experienced visual distortions, including micropsia, macropsia, and teleopsia, and auditory hallucinations, sometimes accompanied by headaches. Her symptoms began during a febrile episode (38 °C). Despite the fever resolving, the symptoms persisted, prompting a hospital visit 3 days later. A neurologic examination revealed no issues, and the only positive test was for SARS-CoV-2. The visual and auditory phenomena gradually diminished over a month and resolved completely 2 months postinfection. The second case involved a 6-year-old girl, also without a history of migraines or epilepsy, who experienced recurring visual distortions, including metamorphopsia and chromatopsi
ALICE IN WONDERLAND SYNDROME AIWS CHILDREN COVID-19 SARS-Cov-2
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