Search tips
Search criteria 


Logo of brjopthalBritish Journal of OphthalmologyVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Br J Ophthalmol. 1992 May; 76(5): 316.
PMCID: PMC504267

Alice in Wonderland syndrome as an initial manifestation of Epstein-Barr virus infection.


We present a patient with serologically confirmed Epstein-Barr virus (EBV) infection who had illusions of size, shape, and colour of objects but none of the typical symptoms and signs peculiar to infectious mononucleosis (IM) except sore throat which developed 2 weeks after the initial visual disturbances. The bizarre feelings about the images of body and objects are called the 'Alice in Wonderland syndrome' due to the similarity with Alice's dreams. The same symptomatology including visual metamorphosia is defined in patients with migraine, epilepsy, intoxication due to hallucinogenic drugs, schizophrenia, hyperpyrexia, and cerebral lesions. Alice in Wonderland syndrome has also been reported in the course of IM.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (208K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Copperman SM. "Alice in Wonderland" syndrome as a presenting symptom of infectious mononucleosis in children: a description of three affected young people. Clin Pediatr (Phila) 1977 Feb;16(2):143–146. [PubMed]
  • Sanguineti G, Crovato F, De Marchi R, Desirello G. "Alice in Wonderland" syndrome in a patient with infectious mononucleosis. J Infect Dis. 1983 Apr;147(4):782–782. [PubMed]
  • Eshel GM, Evov A, Lahat E, Brauman A. Alice in Wonderland syndrome, a manifestation of acute Epstein-Barr virus infection. Pediatr Infect Dis J. 1987 Jan;6(1):68–68. [PubMed]
  • Lahat E, Eshel G, Arlazoroff A. "Alice in Wonderland" syndrome and infectious mononucleosis in children. J Neurol Neurosurg Psychiatry. 1990 Dec;53(12):1104–1104. [PMC free article] [PubMed]
  • TODD J. The syndrome of Alice in Wonderland. Can Med Assoc J. 1955 Nov 1;73(9):701–704. [PMC free article] [PubMed]
  • Hendler N, Leahy W. Psychiatric and neurologic sequelae of infectious mononucleosis. Am J Psychiatry. 1978 Jul;135(7):842–844. [PubMed]
  • Graman PS. Mollaret's meningitis associated with acute Epstein-Barr virus mononucleosis. Arch Neurol. 1987 Nov;44(11):1204–1205. [PubMed]
  • Murdoch JC. The myalgic encephalomyelitis syndrome. N Z Med J. 1989 Jul 26;102(872):372–373. [PubMed]
  • Shepherd C. Myalgic encephalomyelitis--is it a real disease? Practitioner. 1989 Jan;233(1461):41–46. [PubMed]
  • Silber MH. Acute transverse myelopathy in Epstein-Barr virus infection. Case reports. S Afr Med J. 1983 Oct 29;64(19):753–754. [PubMed]
  • Fisher MD, Foley P, Lunsford T. The neurological sequelae of mononucleosis. Indiana Med. 1990 Mar;83(3):190–191. [PubMed]
  • Wadhwa NK, Ghose RR. Acute cerebellar ataxia and infectious mononucleosis. Postgrad Med J. 1983 Jul;59(693):457–458. [PMC free article] [PubMed]
  • Mohanaruban K, Fisher DJ. A combination of cranial and peripheral nerve palsies in infectious mononucleosis. Postgrad Med J. 1986 Dec;62(734):1129–1130. [PMC free article] [PubMed]
  • Mouallem M, Friedman E, Rubinstein E. Inappropriate antidiuretic hormone secretion with infectious mononucleosis. N Engl J Med. 1984 Jul 26;311(4):262–262. [PubMed]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Group