In Syndromes & Disorders

The Elusive Alice in Wonderland Syndrome

alice in wonderland syndrome

The Elusive Alice in Wonderland Syndrome

Imagine you wake up one morning and everything appears to be doll-sized. You are a giant among your things. Alternatively, everything appears to be much larger than you are in comparison. It is as if you are an ant walking in the carpet fibers than appear to be as large as trees. Such distortions of visual perception, while rare, do exist.

Is this possible?

Yes, for a person with Alice and wonderland syndrome, this is the reality of their daily life. They are not taking drugs to induce such hallucinations. These false interpretations of reality, happen in Alice Wonderland syndrome without warning and especially impact the lives of children suffering from this disease.

Distorted Reality

The Alice in Wonderland syndrome symptoms create a strange world, where the person’s perceptions of reality differ significantly from actual reality. Things that are small seem large and the reverse is true. Sometimes the perceptions of a person with the Alice in the Wonderland syndrome switches back and forth between things being distorted to appear bigger than they really are and things being reduced in size.

The Alice in Wonderland syndrome is a rare affliction, named after the young girl character of Alice in the book, Alice’s Adventures in Wonderland written by Lewis Carroll published in 1865. The character of Alice falls down a rabbit hole and discovers many amazing things. In the book, Alice goes on an exciting adventure, but for a person in real life who has Alice in Wonderland syndrome, it is not necessarily an adventure, but more of a torment. The author Lewis Carroll may have actually suffered from the disease, because in his journals he describes that he was afflicted with severe migraine headaches, which are related to this disease. Perhaps his inspiration for Alice’s adventures came from his real experience of this disease.

Feeling like a giant amidst everything else is a form of Lilliputian hallucinations. This label also comes from a book called Travels into Several Remote Nations of the World. In Four Parts. By Lemuel Gulliver, First a Surgeon, and then a Captain of several Ships (later shortened to Gulliver’s Travels) written by Jonathan Swift and published in 1726.

Gulliver, like Alice finds himself in a strange world, first in the hands of the Lilliputians, who are tiny people, the size of one of his fingers, then in the land of the Brobdingnags who are giants when compared to Gulliver. Even though the Alice and Gulliver stories are pure fantasy, they do represent what it feels like for a person who has the affliction of Alice In Wonderland syndrome.

Symptoms

In addition to distortions of shape and size, people who experience Alice in Wonderland syndrome may feel like time is distorted. Everything can be in ultra slow motion or everything can be moving along too quickly. Some sufferers mention that the ground becomes “sponge-like” or that the sense of touch is also distorted. It is possible that sounds are affected as well. Frequently the attacks happen just before going to sleep.

Abigail Moss suffered from this condition since childhood. For her, the episodes occurred almost on a daily basis when she was a young child starting from about age five. They came without warning and lasted for around twenty minutes each time. During an attack, she felt like her body was growing in comparison to the rest of the things in her room.

Her father also had these attacks, so the propensity for having this disease has some genetic determinant. Luckily, for Abigail, the attacks became less frequent as she grew older. Nevertheless, she still has an attack about six times per year, even though she is now twenty-four years old.

For many years, this disease has tormented Abigail. Her doctors were not able to determine the source of her affliction. She was only able to understand what was actually happening to her after she watched an episode of the television program called “House,” where a character on the program had the same problem she was experiencing.

What is Alice in Wonderland Syndrome?

According to How stuff works, Alice in Wonderland Syndrome (AIWS) is also called Todd’s syndrome. A psychiatrist John Todd who lived from 1914 to 1987 named it. He described this rare affliction as Alice in Wonderland syndrome or Lilliputian hallucination. This is a neurological affliction, which causes distortions of the perception resulting in confused orientation and misinterpretations of the real world by the senses.

Excessive Brain Electricity

AIWS comes from the excessive electrical activity of the brain, caused by increased blood flow to the brain. The Alice in Wonderland signs include hallucinations, loss of time, and self-image distortions where a part of the body seems to be rather large or extremely small in relation to the other parts of the body.

Migraines

AIWS is frequently associated with migraine headaches. Those who suffer from migraines often experience some visual distortions just prior to having a headache. Many patients with migraines see bright spots of lights that dart around in their eyes. These are called an “aura.” AIWS relates to this phenomena of seeing “auras.” Sudden excessive flow of blood to the brain causes the parts of the brain that process shapes, sizes, textures, and sounds to be affected.

Prognosis

The onset of the disease usually occurs in childhood. Many children who have this disease naturally overcome it when they become teenagers. However, it is possible that this disease continues into adulthood. Adults typically feel the attacks right before going to sleep.

The condition is very rare. Dr. Grant Liu, who works as a pediatrician in Philadelphia’s Children’s Hospital has made an extensive study of children with this condition. When examining forty-eight patients with the condition, Dr. Lui found that about one-third of the cases arose from some kind of infection, six percent were caused by trauma to the head, and half the cases had an undetermined reason for occurring.

Contributing Factors

AIWS is related to other disruptive brain conditions, such as migraines, epilepsy, and diseases that infect the brain like Epstein-Barr virus (EBV) or brain tumors. Those who suffer from EBV, which is a precursor to mononucleosis, can have the symptoms of AIWS.

Another disease that creates AIWS is temporal lobe epilepsy (TLE). TLE is a form of epilepsy that only affects the temporal lobes, which is the area of the brain responsible for processing perceptual information. When a person has an epileptic seizure in the areas of the temporal lobes, they may experience euphoria and pleasure or in the alternative paranoia and fear.

Alice in Wonderland Syndrome Treatment

Treatment for this condition is in alignment to how a person with severe migraines or epilepsy is treated. Following a strict diet that eliminates food triggers is helpful, such as not eating dark chocolate, red wine and strong cheeses. Having a regular sleeping pattern and not using alcohol is also helpful as an Alice in Wonderland syndrome treatment.

Medications such as anticonvulsants, anti-depressants, and those that create beta blocking or calcium channel blocking effects may be helpful. Rest and simply waiting for an attack to pass (about twenty minutes) is the most effective way to deal with this affliction. Driving a vehicle or operating heavy machinery is not appropriate when experiencing an attack.

Some people, who have this condition, especially when it is not diagnosed properly, may have the feeling they are going insane due to the hallucinations. This is not true. This disease is not a mental disorder, but is a physical imbalance in the brain chemistry. One woman, Helene Stapinski, recounts her experiences with the disease and discovered that her ten-year old daughter also has the same affliction.

Pharmaceuticals, such as those used for the treatment of TLE, may also be useful in reducing the symptoms of Alice in Wonderland syndrome, such as:

  • Gabitril (tiagabine)
  • Keppra (levetiracetam)
  • Lamictal (lamotrigine)
  • Neurontin (gabapentin)
  • Topamax (topiramate)
  • Phenobarbital
  • Zonegran (zonisamide)

Summary

While there is no direct treatment for Alice in Wonderland syndrome, the good news is that those who suffer from this disease experience the most severe parts of it usually during childhood and eventually grow out of it. They are not crazy. Even though the condition is rare, the medical community now recognizes it.

There is a genetic determinant, so that if a person has this disease, it is likely that their children may also experience this disease. Often the disease goes unnoticed because the sufferers do not feel comfortable describing what is happening to them to their physicians.

The bouts of these attacks are short. Most last only a few minutes. The average is about twenty minutes, even though there are examples of where the attacks have lasted for days. Luckily, most people learn how to “ride out an attack.” The attacks dissipate in terms of frequency and severity as a person gets older.

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