October 30, 2013

Alice in Wonderland Syndrome (AIWS)

Alice-in-Wonderland syndrome (AIWS, named after the novel written by Lewis Carroll), also known as Todd's syndrome or Lilliputian hallucinations, is a disorienting neurological condition that affects human perception [source: Wikipedia].

Sufferers may experience objects and people as being smaller than they actually are (micropsia), larger than they actually are (macropsia), or distortions of various types involving other sensory modalities including the sufferer's own body. In simple terms, this condition distorts perception, causing disorientation and a warping of the senses [source: PubMed].

In regard to age associations, it is often diagnosed in childhood, with sufferers often feeling like Lewis Carroll’s character Alice lost in her dreams. Though many people grow out of this condition by their teens, some continue to experience symptoms throughout life, especially at the onset of sleep. Sufferers range in age from children to early or late 20s; with some having it in their 30s.


The Alice in Wonderland syndrome can be triggered by abnormal amounts of electrical activity in the body, resulting in abnormal change in blood flow in parts of the brain responsible for processing visual perception and texture.

Signals sent from the brain to the eyes are disturbed resulting in a variety of symptoms including: hallucinations, lost sense of time and an altered self-image where certain body parts appear disproportionate to the rest of the body.


The condition is commonly caused by migraines, headaches, intoxication from hallucinogens, brain tumors or infection with the Epstein-Barr virus (EBV) [source: Centers for Disease Control] as it may present as the initial sign of EBV infection. AIWS can also be associated with epilepsy and encephalitis.

Alice-in-Wonderland syndrome is a disturbance of perception rather than a specific physiologic change to the body's systems. Diagnosis is presumed when other physical causes have been ruled out and if the patient presents symptoms along with migraines and complains of onset during the day (although it can occur at night).

Another symptom of AIWS is sound distortion, such as every little movement making a clattering sound. This can make a person with AIWS paranoid and afraid to move.


Rest is the prime treatment of choice.

Common treatments for AIWS are similar to those for migraines: beta blockers, anticonvulsants, antidepressants and calcium channel blockers [source: American Academy of Family Physicians].

As temporal lobe epilepsy (TLE) could be a common cause [source: epilepsy.com], treatment for this group of sufferers could include: Topamax (topiramate), Keppra (levetiracetam), Neurontin (gabapentin), Lamictal (lamotrigine), Zonegran (zonisamide), Gabitril (tiagabine), and Phenobarbital.

Chronic AIWS is untreatable and must wear itself out. [source: Wikipedia].


Whatever the cause, the distortions can recur several times a day and may take some time to abate. Understandably, sufferers can become alarmed, frightened, even panic-stricken; however the symptoms themselves are not harmful and likely to disappear with time. The condition is not contagious, and rest is the best treatment.

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