Alice in Wonderland Syndrome: A review & cognitive case report

Objectives: The primary objective of this case report was to provide a case example of what neuropsychological testing may look like in an asymptomatic patient with Alice in Wonderland Syndrome (AIWS). AIWS is characterized by episodic distortions in the perception of one's body schema, surroundings, and sense of time. Given the understudied nature of the syndrome, the secondary objective of this report was to provide basic information about AIWS (via brief literature review) and provide some context for why neuropsychological evaluation may be valuable in the case of patients with AIWS. Methods: A literature review was conducted of studies involving AIWS, only one of which discussed cognitive symptoms of a patient with AIWS. Basic information about AIWS was summarized. A comprehensive neuropsychological evaluation was conducted on a patient with AIWS seeking academic accommodations. Results: The patient demonstrated exceptionally low range performance on measures of construction and memory of a complex figure. Below-average range performances were also noted on measures of processing speed. Discussion: To our knowledge, this is only the second formal documentation of possible cognitive deficits in an AIWS patient. Given the lack of literature examining both the syndrome and its cognitive profile within this patient population, our results suggest that further investigation of cognition in patients with AIWS is warranted.