Alice in Wonderland Syndrome - what is it?

  • August 2, 2023
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Alice in Wonderland Syndrome can cause sensory disturbances

Do parts of your body ever appear too big or too small? Do things around you seem to move very fast or slow? Or do you sometimes get the feeling that everything is unreal? You could be experiencing symptoms of Alice in Wonderland Syndrome. 

Alice in Wonderland Syndrome (AIWS) includes a wide range of unusual perceptions and experiences. AIWS is associated with several diseases and brain conditions, including epilepsy. 

These disturbances can be confusing and distressing. And although the perceptions themselves are not ‘dangerous’, they could be a sign that there’s an underlying problem. So, it’s useful to learn more about Alice in Wonderland Syndrome, and speak to your doctor about your experiences. 

What is Alice in Wonderland Syndrome?

Alice in Wonderland Syndrome is a condition where your sense of perception (how you see, hear, and feel the world around you) gets warped. These experiences usually only last a short time (perhaps a few minutes or hours) but they can last for several days. 

It is believed to be a rare condition, although experts think it may often be misdiagnosed or underdiagnosed. At least one study found that up to 30% of people have experienced some symptoms associated with AIWS at one point in their lives. 

When children have Alice in Wonderland Syndrome symptoms, it’s often linked to infections, such as Epstein-Barr virus, influenza and chickenpox. In teenagers and adults, it’s more likely to be linked to an underlying brain condition, including temporal lobe epilepsy, migraine and brain tumors. 

What’s with the name?

AIWS is named after the Victorian novel Alice’s Adventures in Wonderland by the writer Lewis Carroll. In the book, the main character, Alice, sometimes gets very big, while other times she goes very small. The syndrome was given this name in 1955 by John Todd, a psychiatrist (AIWS is sometimes known as Todd’s Syndrome). 

Some people have speculated that Lewis Carroll had AIWS himself, and was describing his own experiences of strange visual perceptions in his stories. Carroll is known to have experienced severe migraines, and AIWS appears to affect around 15% of people with migraines. 

Related: What’s the link between epilepsy and migraine?

Alice in Wonderland syndrome symptoms

There are at least 40 recognized Alice in Wonderland Syndrome symptoms. These include: 

  • Altered body image: This is probably the most common set of symptoms. In particular, your hands and feet may appear to get bigger or smaller, or you may feel very short or very tall. 
  • Perception of the world around you: Things could seem smaller or further away than they are, or larger and closer. Other times objects may look different. For example, something with a straight edge might seem wavy. 
  • Sense of hearing: You might hear noises that aren’t there, such as voices, laughing or crying. 
  • Disrupted sense of time: Things may seem to happen much faster, or much slower than in reality. 
  • Sense of detachment: You might feel disconnected from yourself or the world around you, almost as if you are outside of yourself. 
  • Hallucinations: You may see things that are not there, such as scary faces, masks or limbs. 

Alice in Wonderland Syndrome causes

Unfortunately, we still don’t know exactly what causes Alice in Wonderland Syndrome. This is partly because it’s a rare condition, which means it hasn’t been studied widely. It’s also because the symptoms don’t usually last very long. This means researchers don’t have many opportunities to do tests to figure out exactly what’s happening. 

That being said, it appears likely that AIWS happens when there is a problem in part of the brain called the temporo-parietal-occipital junction. Our brains ‘make sense’ of the outside world by combining information from all our senses (touch, taste, sight, sound, smell) and the information comes together at this junction. If there is swelling, disturbance, damage or lesions that affect this part of the brain, that could explain why people experience perception problems. 

Should you be concerned about Alice in Wonderland syndrome symptoms?

Generally speaking, Alice in Wonderland Syndrome goes away on its own, and many people ‘grow out of it’. But that doesn’t mean you should ignore the symptoms. Although the ‘episodes’ themselves aren’t dangerous, they could be a sign of an underlying condition which could be serious, including:

  • Epilepsy
  • Migraines
  • Brain tumors
  • Mental health disorders, such as schizophrenia
  • Degenerative brain diseases
  • Bacterial infections

If your doctor diagnoses AIWS, they will usually try to treat the underlying disorder. For example, if you have epilepsy, taking anti-seizure medication can help prevent seizures and also stop you from having AIWS symptoms too. In a similar way, migraine medications and diets can help reduce AIWS symptoms if you have migraines. 

If you’ve ever experienced symptoms of Alice in Wonderland syndrome, it’s definitely worth speaking to your physician about these perception problems. They can help diagnose the problem, and work out if there are any other underlying conditions that need attention. 

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