Alice in Wonderland syndrome (AIWS) may sound sort of like an old wives tale but it is a real syndrome and it does affect certain individuals.
Origin
The condition was named by English psychiatrist John Todd in 1955, after Lewis Carroll’s popular 1865 literature, ‘Alice’s Adventures in Wonderland.’ This is because those who suffer from the condition experience similar situations to those experienced by the book’s main character, Alice.
Alice in Wonderland syndrome’s symptom of micropsia has also been associated to Jonathan Swift’s book, Gulliver’s Travels.
Alice in Wonderland syndrome, according to Cleveland Clinic, is a brain-related condition that disrupts how you perceive your own body, the world around you or both.
It may sound intriguing as it gives a very indifferent perspective, however, it is a rare neurological condition that temporarily disrupts the brain’s ability to process and perceives things.
Alice in Wonderland syndrome is rare as the condition seems to be mostly temporary, which makes research more heinous to compile.
Although there are cases of Alice in Wonderland syndrome in both adolescents and adults, researchers indicates that it is most commonly seen in children.
The syndrome has over 60 associated symptoms, including less frequent symptoms.
It is characterized by the individual being able to recognize the distortion in the perception of their own body.
Symptoms
Th main symptom of this syndrome is changes in individual perceptions of the body. An instance is when a part of the body can feel too big or too small. Or even the entire body feeling too tall or too short.
Individuals with AIWS generally experience illusions of expansion, reduction, or distortion of their body image.
Secondly, those with Alice in Wonderland syndrome often experience a feeling of disconnection from one’s own body, feelings, thoughts, and environment. In this case, an individual experiences one’s own life in the third person.
Going further, we can see it’s not fallacy nor fiction.
People experiencing Alice in Wonderland syndrome can also often experience the feeling of having the body divided in two, can also occur.
Additionally, with AIWS, objects may appear to be closer (pelopsia) or farther away (teleopsia) than they are. These are collectively known as metamorphosias.
Individuals that experience Alice in Wonderland Syndrome also experience disturbances in sound perception. These disturbances can include the amplification of soft sounds or the misinterpretation of common sounds.
AIWS also births the lack of spatial perspective brought on by visual distortion. For example, an object could be moving extremely slowly in reality, but to a person experiencing time distortions, it could seem that the object was sprinting uncontrollably along a moving walkway, leading to severe, overwhelming disorientation.
Causes
The root causes of Alice in Wonderland syndrome remain unknown because it is not commonly diagnosed and documented.
Although, migraines are one of the most common triggers, complete and partial forms of the Alice in Wonderland syndrome exist in a range of other disorders, including epilepsy, intoxicants, infectious states, fevers, and brain lesions.
A common cause, Epstein-Barr virus (EBV), type A or H1N1 influenza, varicella and Lyme disease.
Just like brain tumors, a sudden loss of blood supply to the brain, which can happen with strokes is a possible trigger.
Research has also found that mental health conditions, such as schizophrenia, schizoaffective disorder, and depressive disorders, can trigger AIWS.
Hypotheses
Alice in Wonderland syndrome can be caused by abnormal amounts of electrical activity resulting in abnormal blood flow in the parts of the brain that process and perceive.
Some theories suggest the syndrome is a result of non-specific cortical dysfunction (e.g. from encephalitis, epilepsy decreased cerebral blood flow), or reduced blood flow to other areas of the brain.
Using the radioactive element, Technetium, performed on individuals during episodes of Alice in Wonderland syndrome, it was demonstrated that Alice in Wonderland Syndrome is associated with reduced cerebral perfusion in various cortical regions both in combination and isolation.
Other researchers suggest that metamorphopsias, or visual distortions, may be a result of reduced perfusion of the non-dominant posterior parietal lobe during migraine episodes.
In 2024, scientists conducted a lesion network mapping, where they compared brain scans of people with AIWS to scans from normal healthy people. They found that over 85% of those with AIWS had lesions affecting two areas of the brain, namely the one responsible for visual processing and the one used to perceive size.
Also, there is also an established genetic component for migraines which may be considered to be a possible cause and influence for hereditary Alice in Wonderland syndrome.
Diagnosis
While there is no formally established criteria to diagnose the syndrome and because Alice in Wonderland syndrome is a disturbance of perception rather than a specific physiological condition, it can be poorly diagnosed.
However, health providers may conduct certain tests, even if to rule out other conditions. These may include imaging tests (e.g. CT scan, MRI, etc.).
During these tests, symptoms need to be distinguished from other disorders that involve hallucinations and illusions.
Meanwhile, Alice in Wonderland syndrome, after conducting in depth analysis and evaluation is difficult to be misdiagnosed or confused.
Treatment
Presently, there is no treatment (or cure, as such) for AIWS, other than managing the symptoms as the symptoms can disappear, either spontaneously on their own, or with the treatment of the underlying disease.
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