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What is 'Alice in Wonderland syndrome'?

Researcher & Writer: Ruka Arakaki

Illustrator: Ellie Liu


What is Alice In Wonderland Syndrome?

Alice In Wonderland Syndrome (AIWS) is a rare neuropsychological condition that disrupts one’s perception of the world, themselves, or both. It can also distort one’s sense of reality. AIWS seems to occur mainly in children with research studies showing that nearly two-thirds of cases happen in people under the age of 18. Additionally, AIWS is more likely to occur in those who have certain brain-related conditions. AIWS is also known as Todd’s syndrome because it was first recognised by Dr. John Todd, a British psychiatrist. He stated that the symptoms presented resembled episodes that the main character Alice Lidell experienced in the famous novel, “Alice in Wonderland”.


What does one experience with AIWS?

Symptoms can be different for each individual. What one experiences can vary from one episode to another. Usually, an episode lasts for a few minutes however, some can last up to half an hour. During an episode one might experience:



Migraines:

  • Some researchers and doctors actually believe that AIWS is an ‘aura’ meaning that it is an early sign of the development of migraines. Others believe that this is a subtype of migraine.


Size Distortion:

  • During an episode of AIWS, one can experience two types of size distortion, micropsia, and macropsia.

  • Micropsia is the sensation that your body or the objects around you are shrinking.

  • Macropsia is the sensation that your body or the objects around you are enlarging.


Perceptual Distortion:

  • If one feels that the objects around them are growing closer to them than they really are or enlarging, this is called pelopsia.

  • If one feels that the objects around them are moving further away or is shrinking, this is called teleopsia.

  • One can also suffer from derealisation which is a form of disassociation where one feels disconnected from the world.


Time Distortion:

  • Some people who have AIWS can lose their sense of time.

  • They may feel that time is moving slower or faster than it really is.


Sound Distortion:

  • Quiet sounds may seem loud and intrusive to some and vice versa.


Loss of limb control and coordination:

  • This happens when muscles feel like they’re acting involuntarily meaning one may not feel like they’re controlling their limbs.

What causes Alice in Wonderland syndrome?

There isn’t a fixed cause of the syndrome at the moment however, researchers believe that it is due to unusual electrical activity in the brain leading to abnormal blood flow which could be the reasoning behind perception issues. Some possible causes of the syndrome are migraines, infections, stress, cough medicine, epilepsy, specific strokes, brain tumors, mental health conditions, and degenerative brain diseases.


How is AIWS diagnosed?

For AIWS, there isn’t a specific test that can be done solely for this condition. However, doctors can do tests to rule out or find explanations for the symptoms presented. Some tests include:


MRI scans

- Produces highly detailed images of organs and tissues


CT scans

- Uses x-rays and computers to produce images of a cross-section of the body


Spinal Tap

- Collects cerebrospinal fluid to check for infections, inflammation or other diseases


Electroencephalogram (EEG)

- Analyses the electrical activity in the brain


Visual evoked potentials

- Analyses the eyes and the signals they send to the brain to ensure the optic nerves are working correctly.

Overall, as rare as this syndrome is and as disorienting as the symptoms may be, they aren't harmful. AIWS episodes can happen throughout an entire day but then one might not experience them for several weeks or months. People will most likely experience fewer symptoms over time and by the time they reach adulthood, the syndrome might not be present anymore.



Bibliography

Alice in wonderland syndrome (AIWS): Symptoms & treatment. Cleveland Clinic. (n.d.). Retrieved February 23, 2023, from https://my.clevelandclinic.org/health/diseases/24491-alice-in-wonderland-syndrome-aiws


Holland, K. (2019, April 17). Alice in wonderland syndrome: Symptoms, treatment, and more. Healthline. Retrieved February 23, 2023, from https://www.healthline.com/health/alice-in-wonderland-syndrome#outlook


Depersonalization/Derealization Disorder: Symptoms & Treatment. Cleveland Clinic. (n.d.). Retrieved February 23, 2023, from https://my.clevelandclinic.org/health/diseases/9791-depersonalizationderealizationdisorder#:~:text=Disconnected%20from%20your%20environment%20


CT scan (Computed Tomography): What is it, Preparation & Test details. Cleveland Clinic. (n.d.). Retrieved February 23, 2023, from https://my.clevelandclinic.org/health/diagnostics/4808-ct-computed-tomography-scan





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