Alice in Wonderland Syndrome. Seven surprising facts about this mysterious disease

If you don’t know what Alice in Wonderland Syndrome (AIWS) is, no wonder. Although this disease is real, sometimes even some medics have not heard of it. This neurological disorder can accompany conditions such as epilepsy and migraines. It is most commonly diagnosed in children, although this may be due to the reluctance of adults to describe the extremely strange symptoms and visions they experience.

  1. People with Alice in Wonderland syndrome have episodes where objects, or even parts of their own body, may appear much smaller or much larger than they really are
  2. The Alice in Wonderland Syndrome was first described in 1952 and was named after it in 1955 by the English psychiatrist John Todd, obviously in honor of the famous novel by Lewis Carroll
  3. It is not excluded that Lewis Carroll himself also suffered from AIWS
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What is it like to have Alice in Wonderland Syndrome?

1. Things appear much larger or much smaller than they really are

People with AIWS report that they perceive changes in their environment. Typically, an attack involves micropsy where objects appear small, or macropsy where things appear much larger than they really are. In some cases, not only the observed objects appear to change in size. It happens that the patient himself perceives his body parts in a distorted and disproportionate way. Such disturbances can last literally a few seconds or be prolonged.

Such strange visions and distortions of perception make people experiencing AIWS feel a great deal of anxiety, especially when they are confronted with an episode of the disease for the first time.

  1. See also: Hallucinations – types and causes of occurrence

2. Lewis Carroll himself may have had the AIWS

Lewis Carroll was the author of Alice’s Adventures in Wonderland and it is very possible that the well-known book was influenced by his own migraine experiences.

In the story, Alice finds a bottle with the words “Drink me”, and when she does, it shrinks. Almost immediately after the incident, she eats a cookie which makes it grow until it hits the ceiling with its head. There are many indications that the author himself had migraine attacks. Based on his memoirs, it is speculated that he, too, may have experienced the Alice in Wonderland syndrome that entered the book’s plot.

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3. Experts aren’t sure what causes Alice in Wonderland Syndrome

It is not known exactly what makes people perceive objects as larger or smaller than they actually are. There are some theories based on human anatomy. According to experts, the Alice in Wonderland syndrome accompanying migraine may originate in the parietal-occipital part of the brain. The parietal area is related to body and space perception, and the occipital area is related to vision. When AIWS is associated with epilepsy, it appears to originate in the frontal lobe. However, there is still a lack of unequivocal studies confirming the neurologists’ guesses.

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4. AIWS is rare but may be underestimated

Alice in Wonderland Syndrome is so rare that many experts may never encounter it in their medical careers. To date, no epidemiological studies have been conducted to show how common AIWS is present in the population. According to a review published in the “Neurology Clinical Practice”, there is no commonly accepted way to diagnose this syndrome. The symptoms of Alice in Wonderland syndrome cause anxiety in adults. Some of them fear that they will be considered mad or mentally ill because what they experience resembles unreal hallucinations. Therefore, it is extremely rare to diagnose this mysterious disease.

5. Alice in Wonderland Syndrome can be part of the aura during a migraine attack

Although AIWS is very rare, it is often associated with migraine. The symptoms are part of the so-called aura, however, an episode of Alice’s Team in Wonderland can also happen during a headache. Like other migraine aura experiences, the changes in perception induced by AIWS can occur without a headache.

6. AIWS may also be associated with epilepsy, infections, and other neurological disorders

Alice in Wonderland Syndrome may also be associated with temporal epilepsy and some viral infections, such as influenza or mononucleosis.

Infectious mononucleosis is most often caused by the Epstein-Barr virus (EBV), a type of herpesvirus and one of the most common human viruses. In rare cases, EBV can lead to complications such as brain swelling, which is often the cause of AIWS in children.

Rarely, Alice in Wonderland syndrome is a symptom of a stroke or brain tumor, and in such cases the patient usually has many other symptoms.

AIWS can also be caused by certain chemicals and drugs with hallucinogenic properties (e.g. drugs such as LSD).

7. Treatment consists of treating the underlying disease

Although the World Health Organization (WHO) has not issued standard guidelines for the diagnosis of AIWS, it is strongly recommended that when symptoms are present, a variety of potential causes be investigated. Blood tests, brain magnetic resonance imaging, and EEG testing may help.

  1. EEG detects changes in brain activity and can be used to diagnose epilepsy and other seizure disorders
  2. Magnetic resonance imaging can help diagnose conditions such as a tumor, infection, swelling, or damage from an injury or stroke
  3. Migraine diagnosis is done with a physical examination and a thorough medical history.

The treatment of this mysterious disease depends on what causes the visual impairment. This means that it is not AIWS that is treated, but the underlying disease in which its episodes occur.

Something happens in the course of a migraine or other underlying disease that triggers a patient’s perceptual disturbance. This is the only thing that distinguishes Alice in Wonderland Team from hallucinations or delusions.

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