A cardinal alteration in AIWS is the unbalance between the self-representation and/or the perception of the real world.
Additionally, it was found in a study carried out in Japanese population with 3224 subjects between 13 to 18 years old that occurrence of micropsia and macropsia was 6.5% and 7.3% in males and females, respectively, suggesting that visual illusions in AIWS are not as infrequent as usually believed.
Undoubtedly, it could be said that the so called AIWS is a clear example of what used to be defined as cryptogenic--a clinical manifestation of apparently unrelated pleiotropic symptoms, with a secret background, a neurological etiology lying inside the depths of the neural fabric.
Notwithstanding the fact that AIWS lacks explicit classification criteria, Valenga et al (5) suggested the following diagnostic criteria for AIWS-associated migraine in 2015: 1 or more episodes of body distortions or metamorphopsias; duration <30 minutes; accompanied by headache or with a history of migraine; and normal MRI, cerebrospinal fluid, and electroencephalogram (abnormal visual evoked potentials).
About 166 cases of AIWS have been published in the literature, identifying various types of conditions associated with the syndrome.
AIWS remains a poorly known and probably misdiagnosed syndrome.
In this review, we will discuss the original description of perceptual alterations by Lewis Carroll and will frame them into the main clinical features of AIWS as presented in several case reports.
A literature review was carried out in PubMed using "AIWS" and "Alice in Wonderland Syndrome" as key words that produced 148 results.
However, the first that used the term of Alice in Wonderland Syndrome (AIWS) was Todd, in 1955.
Since 1955, about 170 cases of AIWS have been reported in literature.