Alice in Wonderland Syndrome

All of us have heard about Lewis Carroll’s fictional work Alice in Wonderland. In the book, Alice goes through a series of hallucinating experiences when she falls into a deep hole, while following a rabbit. These included illusions like being just ten inches tall and acquiring different sizes after eating a cake.  What Alice experienced is a reality for some people as things don’t look the way they should for these people.

For such people, straight lines may look undulating, objects may seem to move when they are actually still, people too may look distorted and colors may change. Objects may also appear smaller (micropsia) or bigger (macropsia) than they actually are.

 Alice in Wonderland syndrome or AIWS is a neurological and psychological condition that is common in children.  It may be best described as a perceptual disorder. The patients have visual delusions and have a feeling of distorted body, time and space image. They think their body or some of the parts of the body have changed in shape and size. 

AIWS, also known as Todd’s syndrome was first identified by British psychiatrist John Todd. Todd named it after the famous fiction, Alice in Wonderland by Lewis Carroll. Apparently, Lewis Carroll did experience severe migraine and Lilliputian delusions.

Adults can experience the Alice in Wonderland syndrome too, as in the case of Robert Williams, an Australian father of two children. Williams may look like another normal human to the world, but that really doesn’t seem to be the case.

Williams told Mirror UK “You can imagine how terrified I was. I just wanted it all to go away. I would end up wide awake, in floods of tears. You could be gazing at an object, like a painting on your living room wall, and then suddenly it pops right up in your face. It feels like the room is caving in on you.”

Williams has now started a face book page which shares the experiences of people with AIWS syndrome. Despite his condition, Williams is quite positive on leading a normal life.

Though the episodes of AIWS are of short duration (less than an hour), they can occur multiple times in a day. There is no clarity on what causes AIWS; but it is believed that migraine, brain tumors, stress, temporal lobe epilepsy, Epstein-Barr virus infection and certain psychoactive drugs could be the reasons. Most of the patients who suffer from AIWS have a family history of migraine or experience migraine themselves.

As per a 2008 report by Dr. Sheena Aurora, a Stanford specialist, best known for performing an MRI scan on the brain of a 12-year old in the midst of an episode, electrical activity causes unusual blood flow to the parts of the brain that control vision and process texture, shape, and size. According to Dr. Aurora “The brain of someone with Alice in Wonderland syndrome is just a little bit different from those with other auras”.

Though the bouts of AIWS could be terrifying and can cause panic in patients, these symptoms are not generally dangerous or harmful.  Lingering symptoms may not be treatable and need to wear out on their own with time.  While there is no known effective treatment regime for AIWS, a broad migraine treatment plan with anticonvulsants, antidepressants, calcium channel blockers and beta blockers should give some relief. Establishing a healthy migraine diet regime and avoiding trigger foods that cause migraine can also be of immense help. 

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