Alice In Wonderland Syndrome | Neurological Disorder

Alice In Wonderland Syndrome or AIWS (in short) is a neurological condition where a person views reality differently. In this kind of disorder, the patient observes an object as either small or large. Though most patients experience visual distortions, some can even have auditory distortions, changed body perceptions, hallucinations, time distortions, etc.

Alice in the story ‘Alice in Wonderland’ had visual perceptions that kept changing throughout her journey, Sometimes she became small after drinking a liquid and sometimes large after eating a cake. What may be described as her bodily transformations, could easily be her own visual perceptions changing within her mind.

Because the symptoms of the illness are similar to the story’s narrative, the name has been given the same- ‘Alice in Wonderland Syndrome’. In the story, the experiences may appear entertaining but in reality, it can be nightmarish for the ones experiencing it.

It is also termed as Todd’s syndrome after Dr. John Todd, a British psychiatrist. He was the one who first identified and recorded the symptoms. People experiencing Alice In Wonderland Syndrome consists of 10-20% of the population. Though the numbers may seem huge, the illness is not as harmful as it seems. It is a rare disease among adults.

The hallucinations affect Mostly children and teenagers but the symptoms subside naturally after some time. They get better as they grow. Generally, duration ranges from 5- 10 minutes, and it can span for a maximum of 2 days. The episodes of hallucinations are short-lived and temporary. That is why not much research has been done on AIWS. Also, this disorder is quite different from visual agnosia. One must not confuse with it.

Types of Alice In Wonderland Syndrome

There are numerous types of AIWS but the majority of the illness fall under one of the categories listed below-

1. Micropsia: The patient perceives an object as smaller than reality.
2. Macropsia: The patient perceives an object as larger than reality.
3. Pelopsia: The patient perceives an object as nearer than reality.
4. Teleopsia: The patient perceives an object farther away than reality.
5. Microsomatognosia: The patient perceives their body parts as shrinking.
6. Macrosomatognosia: The patient perceives their body parts as expanding.
7. Time distortions: The patient perceives time as either slower or quicker than reality.
8. General hallucinations
9. Hearing distortions

Causes of Alice In Wonderland Syndrome

• Side-effects of childhood development of the brain

• Epstein-Barr Virus: According to research, the Epstein-Barr Virus (EBV) causes about 48% of the severe cases of AIWS.

• Migraine/ headache

• Stress

• Epilepsy

• Mind-altering drugs

• Neurological causes: Brain lesions/ tumors on parietal and temporal lobe can cause abnormal electrical activity and blood flow leading to hallucinations.

• According to a renowned neurologist Dr. Aurora, abnormal blood flow in the occipital lobe (involved with eye functions) of our brain can cause visual illusions of such nature.

Symptoms of Alice In Wonderland Syndrome

The symptoms of AIWS are typically hallucinations of all sorts- like visual, auditory, time, body perceptions. Apart from that, it can also accompany severe headaches, swelling, and dizziness. In extreme and rare cases, memory loss can also occur.

However, it should not be confused with psychosis. Because it is not a psychological problem but a neurological one.

Diagnosis

The Alice In Wonderland Syndrome is not harmful in general. This type of visual and other kinds of hallucinations don’t cause severe long term health problems. In children, the symptoms fade away after a few episodes. However, if the symptoms don’t disappear or if it reappears in adulthood, then some diagnosis may be needed.

1. Brain fMRI scanning for identifying brain lesions and tumors
2. Blood tests for EBV and other types of influenza virus
3. EEG (Electroencephalogram) for detecting any abnormal electrical activity in the brain.

Treatment

There is no direct treatment for AIWS. However, we can take precautionary measures.

Medications for migraine can help if the person suffers from headache along with AIWS. For epilepsy-related symptoms, antiepileptic medicines are administered.

If a child is suffering from it, I think, more importantly, parents must not panic. They should emotionally support the child and keep monitoring the condition for a few weeks. If the condition aggravates instead of subsiding (which is very rare), you must contact a neurologist immediately for a check-up. Overall it is a relatively non-harming neurological disorder and goes away after some time.

Other remedies

Though it is a neurological condition, psychologists can help AIWS victims to a great extent. There are various kinds of techniques a psychologist can use and recommend.

1. Meditation
2. Cognitive-behavioral therapy (CBT)
3. Talk therapy
4. Proper sleep
5. Proper diet
6. Exercise

AIWS is not a psychological problem. But, therapists or psychologists can help overcome the confusion and anxiety of the patients that the syndrome entails.

References

• Healthline
• WebMD
• Medical News Today