With recent advances in anatomical and functional brain mapping, Alice in Wonderland syndrome (AIWS), a perceptual distortion disorder, has received increased attention. We report the case of a 67‐year‐old man with bipolar I disorder (manic episode), AIWS, and delusional parasitosis (Ekbom syndrome). The patient exhibited diverse perceptual distortions across visual, auditory, and tactile modalities. In addition to derealization and depersonalization, he showed a distorted sense of time. Single‐photon emission computed tomography (SPECT) revealed a transient but significant decrease in blood flow in the right posterior cingulate region, accompanied by relatively increased blood flow in the bilateral occipital regions during the episode.
Hori et al. (Thu,) studied this question.