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“Alice in Wonderland syndrome” associated with topiramate for migraine prevention
  1. T P Jürgens1,
  2. K Ihle1,
  3. J-H Stork2,
  4. A May1
  1. 1Department of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
  2. 2Department of Anaesthesiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
  1. Correspondence to Dr Tim P Jürgens, Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg D-20246, Germany; t.juergens{at}


Various visual and sensory phenomena have been described in migraine with aura. Among those, the “Alice in Wonderland” syndrome is defined as a distortion of the body image with the patient being aware of its unreal nature. Here, the case of a 17-year-old girl with migraine without aura who developed an ‘Alice in Wonderland’ syndrome repeatedly on topiramate treatment was presented and potential pathophysiological concepts were discussed.

  • Alice in Wonderland
  • topiramate
  • migraine
  • pseudohallucination
  • visual illusion
  • headache
  • migraine

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.