The evidence suggesting no significant neurological deficits accompanying the visual disturbances includes the absence of changes in consciousness, posture, or automatisms during the episodes of AIWS. These factors imply that, although the visual perceptions were distorted, the patient's neurological functioning remained stable, and there were no additional impairments typically associated with more severe neurological conditions [Tunç & Başbuğ, 2017].

The administration of escitalopram correlated with the resolution of AIWS symptoms in the patient. Escitalopram, an antidepressant, was used to address depressive symptoms, which may have a connection to stress or neurological factors influencing AIWS occurrences. The gradual increase and six-month duration of treatment until symptom disappearance suggest a possible adjunctive effect of antidepressants on alleviating perceptual disturbances associated with AIWS [Tunç & Başbuğ, 2017].

The psychological support, including psychoeducation, aimed to address AIWS symptoms by providing reassurance about the temporary and non-threatening nature of the optical abnormalities. This approach likely helped reduce feelings of anxiety or confusion by offering the patient understanding and coping mechanisms, emphasizing the importance of recognizing these perceptions as non-real and temporary, thus enhancing her sense of control over the experience [Tunç & Başbuğ, 2017].

The recommended coping technique for the patient was to leave the place where she experienced disturbing visual sensations. This strategy addresses AIWS episodes by removing the patient from the environment that might trigger or exacerbate perception disturbances, thereby reducing the immediate impact and allowing her to recognize these abnormalities as temporary and non-threatening [Tunç & Başbuğ, 2017].

The familial migraine history, including the juvenile migraine with aura in the patient and migraines in her mother, suggests a possible genetic or hereditary component in the development of AIWS. It implies that a predisposition to neurological disturbances, like migraines with aura, may be a contributing factor, thereby enhancing the understanding of AIWS as potentially linked to migraine-related anomalies in perception [Tunç & Başbuğ, 2017].

The patient's visual perceptual disturbances manifested as magnified or color-altered views of her surroundings, such as seeing objects or people's heads as larger or different in color than they are. Despite these distortions, her actual awareness remained, evidenced by her understanding that her mother, whom she visually perceived as distant, was indeed beside her. This discrepancy highlights a distinction between altered visual perception and cognitive awareness of reality [Tunç & Başbuğ, 2017].

The treatment for the patient's AIWS symptoms and depression involved administering escitalopram for depressive symptoms, which was gradually increased. The medication was taken for six months until the AIWS and depression symptoms disappeared. Psychoeducation played a crucial role by teaching coping techniques, such as leaving the location where disturbing visual perceptions occurred, and reassuring the patient that the optical abnormalities were not real and would pass [Tunç & Başbuğ, 2017].

The primary characteristics of Alice in Wonderland syndrome (AIWS) in this case include visual perceptual disturbances where the patient sees her cat and household items as larger and in different colors than normal. She also reported seeing her father's head as blue and larger, letters growing larger while reading, and notes appearing closer during study. Additionally, she perceived her mother to be about 20 meters away despite knowing she was right next to her. There were no changes in consciousness, posture, or automatisms during these episodes [Tunç & Başbuğ, 2017].

The patient's history of juvenile migraine with aura, reported since the age of seven, potentially impacted the development of AIWS symptoms. Migraine aura can include visual disturbances, and it is possible that this predisposition contributed to the unusual visual perceptions noted in AIWS. Furthermore, a history of migraines in her mother suggests a genetic link that might influence the sensitivity to visual changes [Tunç & Başbuğ, 2017].

During episodes of AIWS, the patient's perception distortions, such as seeing enlarged and color-altered objects or misjudging distances, could significantly disrupt daily activities. These distortions may cause difficulties in tasks that require accurate perception, impact social interactions due to unusual behavior responses, and potentially increase anxiety or stress, complicating her overall well-being [Tunç & Başbuğ, 2017].