"Alice in Wonderland" Syndrome as a Presenting Symptom of Infectious Mononucleosis in Children

Abstract

Three cases of "Alice in Wonderland" syndrome (metamorphopsia) are presented and described as a presenting symptom of infectious mononucleosis in a preadolescent male and in two late teenage females. In each instance, the classical infectious mononucleosis symptoms and diagnosis followed the onset of visual aberration. Thorough physical and blood examination of patients who present with such a syndrome must be undertaken before these symptoms are ascribed to psychiatric abnormalities. It is emphasized that infectious mononucleosis is a diffuse disorder, often associated with encephalopathies, which may include visual imbalance symptoms.