Mononucleosis: Alice in Wonderland symptoms?
My daughter has recently been diagnosed with the "Alice in Wonderland" symptom with mononucleosis. I understand this is very rare, and I am hoping to find some information about it. She is seven years old and has had this for about a month. How long will it last and what all can I expect?
Question:Robert Steele
Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more
One of the most famous parts of the book, Alice in Wonderland, tells of her adventures of becoming small and tall as she tangles with the Mad Hatter, the Cheshire Cat, and a whole host of other characters. Anyone who has viewed the illustrations of this famous story will remember the strange dimensions of Alice's body as compared to her environment. People with the Alice in Wonderland syndrome feel like their bodies and the objects around them are going through these same changes. Examples of these feelings include having the sensation of being very tall, feeling like the neck is stretched very long like a giraffe, or perceiving one half of the body is much larger than the other. Probably the most distressing thing for the person who has this is that they know this can't be correct. They may look in the mirror only to be surprised that what they see is not what they feel.
Several illnesses that involve the brain can cause these strange body perceptions. However, the two most common causes are migraine headaches and infection with the Epstein-Barr virus, the virus that causes infectious mononucleosis. It has been known for a long time that migraine headaches can have other unusual symptoms in children. In fact, the Alice in Wonderland symptoms were first described to be associated with these headaches back in 1952. In some respects, it shouldn't be surprising that Mono could also cause this syndrome because it has been known this infection can also cause a wide variety of other neurologic complications. However, it wasn't until 1977 that it was realized this infection could likewise cause these bizarre symptoms. Moreover, the Alice in Wonderland syndrome may be the only symptom of infectious mononucleosis.
There isn't any known cure for the Alice in Wonderland symptoms caused by Mono primarily because the exact mechanism remains unknown. Fortunately, these symptoms seem to always resolve within five months. This complication of Mono is rather rare which limits our understanding of it. Nonetheless, it seems to cause no long lasting effects.
As you can imagine, these thoughts may be quite frightening for your daughter. Realize she may compensate by regressing somewhat in the social aspects of her life. I encourage you to keep the rest of her life as normal as possible while being supportive. Also, be sure and talk to her about what she is feeling because she may be reluctant to offer this information on her own.
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