Cerebral perfusion in children with Alice in Wonderland syndrome

Pediatr Neurol. 1998 Aug;19(2):105-8. doi: 10.1016/s0887-8994(98)00037-x.


Alice in Wonderland syndrome (AIWS) is characterized by visual hallucinations and bizarre perceptual distortions. Technetium-99m hexamethylpropyleneamine tomography (SPECT) brain scans were performed in four patients during the acute stage of AIWS. Two patients were demonstrated to have Epstein-Barr virus infections. One had abnormal (EEG) findings. The visual-evoked potential, cranial CT, and MRI findings were negative. The decreased cerebral perfusion areas in all patients were near the visual tract and visual cortex. All involved some regions of the temporal lobe. In most patients with AIWS, the EEG, CT, and MRI are unable to determine the precise pathologic areas. However, a SPECT brain scan may demonstrate abnormal perfusion areas and explain the clinical presentations.

MeSH terms

  • Cerebrovascular Circulation / physiology*
  • Electroencephalography
  • Epstein-Barr Virus Infections / complications
  • Female
  • Hallucinations / diagnostic imaging
  • Hallucinations / physiopathology*
  • Hallucinations / virology
  • Humans
  • Infant
  • Male
  • Perceptual Disorders / diagnostic imaging
  • Perceptual Disorders / physiopathology*
  • Perceptual Disorders / virology
  • Syndrome
  • Technetium Tc 99m Exametazime
  • Tomography, Emission-Computed, Single-Photon
  • Visual Cortex / blood supply
  • Visual Pathways / blood supply


  • Technetium Tc 99m Exametazime