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Bulgarian Review of Ophthalmology

On The Alice In Wonderland Syndrome With A Case Report

S. Cherninkova, R. Petkov


Alice in Wonderland syndrome is a rare neurological disorder characterized by transient distorsion of visual perception, impaired perception of one’s own body and time sometimes along with derealization and depersonalization. One of the rare visual symptoms of this syndrome is inversion of visual perception, consisting of rotating or inverting the image of the observed environment lasting several seconds or minutes. The transient inversion of visual perception is thought to be the result of dysfunction of the parieto-insular vestibular or parieto-occipital cortex. We present a 6-year-old boy (М.М.К.) who informed his parents about three episodes of “rotation of the images” in front of him in the last several weeks, lasting 1-2 minutes and abruptly disappearing. Conducted neurological status, neuro-ophthalmological examination, electro-encephalography did not show the presence of abnormalities. MRT of the brain revealed the only pathologic finding – mild unilateral (left) lateral ventricular dilatation due to left foramen of Monro stenosis, interpreted as congenital. We hypothesize that mild unilateral hydrocephalus may be an etiological factor in our patient and cause transient cortical dysfunction and visual-spatial imbalance with impaired verticality.


Alice in Wonderland syndrome, inversion of visual perception

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About The Authors

S. Cherninkova
Clinic of Neurology, University Alexandrovska Hospital, Medical University ‒ Sofia

R. Petkov
Department of Radiology, University SofiaMed Hospital ‒ Sofia