By: Nysa Vinod & Aaria Lankireddy
What Is Alice in Wonderland Syndrome?
Alice in Wonderland Syndrome or Todds Disease is a neurological condition found in the brain of children and young adults. This syndrome is abbreviated as AIWS. AIWS consists of metamorphopsia (seeing something in a distorted manner). This condition disrupts eyesight and makes things seem larger (macropsia) or smaller (micropsia) than they are. It can also change the way you perceive your body. It was first discovered by Dr John Todd in 1955 while treating his patients. In Lewis Carroll’s Alice in Wonderland, Alice saw objects in odd forms. Some items decreased in size while others increased. Dr. Todd saw similar symptoms and named the founded disease Alice in Wonderland aka Todd's disease.
Symptoms
This syndrome can be accompanied by severe migraines or epilepsy, which can be debilitating and leave people paralyzed with symptoms for several hours or even days. “The symptoms of Alice in Wonderland are separated into 3 different categories: Self-perception and Visual perception and combined” (Cleveland Clinic, 2023).
Self-perception: The feeling of being split into 2, This is a disruption in the sense of time, and changes your perception of your body. You may have a distorted body image your body parts might appear to shrink or swell, or parts of the body may feel too big or too small.
Visual perception: AIWS changes how you perceive the world. For example, someone could have an arm sticking out of their face or have 1 long arm and one very short arm. You could have a distorted perception where objects or people could appear differently. An object may seem to move in slow motion or unnaturally fast. Microspia, where objects appear smaller or Marcropsia where objects look bigger than their original size (Holman, HCA, 2024). For example, there could be a book that was bigger than average. A person with micropsia might experience visioning a smaller size than a regular size of a book. A person with marcopsia seeing a mini Lego set would experience seeing legos in larger sizing.
Combined: This is when you get both symptoms of Visual and Self Perception combined.
What is the cause?
Scientists and doctors don’t know the exact reason for this condition. Some causes could be
Migraines & Aura in Migraines
Eye diseases
Epstein-Barr Virus (common in children)
Influenza A
Medications (including cough syrups)
Brain Lesions
Psychiatric Disorders/Depression ( common in adults)
Hallucination
Strokes
Mycoplasma
Varicella-zoster virus
Lyme neuroborreliosis
Typhoid encephalopathy
Streptococcus pyogenes, also known as scarlet fever
Tonsillopharyngitis
Epilepsy (common in adults)
How can you detect it?
If you suspect that you have Alice in Wonderland syndrome (AIWS), your doctor will ask about your symptoms and might conduct a neurological or ophthalmic (eye) exam. Other tests that may be used to diagnose AIWS include:
MRI brain scan, any abnormalities/tumors can cause AIWS
Blood tests to rule out or diagnose underlying viruses or infections
Neurological and psychiatric consultations
EEG to test the electrical activity in the brain.
Treatment Options
The cause of AIWS is hard to pinpoint and treatment options are difficult because of the unknown cause. However, once doctors find the cause of symptoms, they can start treating it. Doctors will sometimes alleviate AIWS by prescribing therapy, a migraine diet, and anti-psychotic drugs/anti-epileptics drugs, which are used for treating and preventing seizures that can lead to AIWS. Some medications include “migraine prophylaxis, anticonvulsants, antidepressants, calcium channel blockers, and beta blockers” (Holman, HCA, 2024). In most cases, “AIWS resolves over time” (UNMC, 2023).
References
Professional, C. C. M. (n.d.-a). Alice in Wonderland Syndrome. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24491-alice-in-wonderland-syndrome-aiws
The mystery of Alice in Wonderland syndrome. (2023, March 14). The Transmission. https://www.unmc.edu/healthsecurity/transmission/2023/03/14/the-mystery-of-alice-in-wonderland-syndrome/#:~:text=A%20wide%20range%20of%20causes,such%20as%20depression%20and%20schizophrenia.
Millar, H. (2023, June 26). What is Alice in Wonderland syndrome? https://www.medicalnewstoday.com/articles/alice-in-wonderland-syndrome Alice in Wonderland syndrome: What is it and who is at risk? | HCA Houston Healthcare. (n.d.). HCA Houston Healthcare. https://www.hcahoustonhealthcare.com/healthy-living/blog/alice-in-wonderland-syndrome-what-is-it-and-who-is-at-risk