Odd Medical Conditions: Alice in Wonderland Syndrome

In the well-known children's story, Alice's Adventures in Wonderland, Alice experiences many strange and wonderful things. Partaking of mushrooms and other substances, her perception is distorted, and she feels herself growing larger and larger, or smaller and smaller. The author of the book, Lewis Carroll, has often been derided for what appear to be drug references in a child's tale.

Now we understand that Mr. Carroll may have experienced this distortion himself, without the use of psychoactive drugs. Alice in Wonderland syndrome (AIWS) is an unusual, temporary neurological condition that alters the patient's sense of time, space, size, and body image. In his writings, Lewis Carroll mentions his affliction with migraines at least once. The inspiration for the imagery in the story may have come from hallucinations associated with the migraine aura sufferers may experience before the actual onset of the migraine.

The condition is in the neurological perception, not in the physical mechanics of the eye. Objects may appear extremely far away but close at the same time. Other people may appear to be tiny. Parts of the patient's body may appear to have been altered in shape or size. Other symptoms, such as a feeling of levitation, anxiety, apraxia (difficulty controlling speech or movement), and agnosia (lack of ability to recognize familiar sounds, objects, shapes, smells, or people) may be present.

Although these perceptions are often associated with the use of psychoactive drugs, dextromethorphan in particular, the condition has been found to accompany classic migraine headaches or epilepsy. Patients with schizophrenia, or delirium from fever, may experience AIWS. Some find it occurs as they fall into the dreamlike state between wakefulness and full sleep, or upon awakening. Occasionally, Alice In Wonderland syndrome may be the first symptom of mononucleosis.

The syndrome appears to be most common in children five to 10 years old. The senses of hearing and touch may also be affected. The syndrome tends to occur during darkness, and continues even when the eyes are closed.

The hallucinations can take a variety of forms, and the patient is usually aware that they are hallucinating. The patient may be standing still and feel the walls are going by at 50 miles an hour, or can see the bed is not moving but feel it floating in midair as they lay upon it. Vision may be normal in one eye but grossly distorted in the other. Solid ground may feel "spongy" as it is walked upon. Symptoms and perceptions are as individual as the patients themselves.

AIWS symptoms may be frightening for the sufferer. They may think they are going crazy, and keep the experience to themselves, not even confiding in their physicians. This disorder has not been well-known, even among physicians, and patients may be misdiagnosed or visit several doctors before they are given the encouraging news that this is only a strange side-effect of an underlying disorder, usually migraine or epilepsy. With the exception of schizophrenic patients, who often accept distortion as reality, AIWS does not necessarily reflect upon the sufferers' mental health!

While there are no specific treatments for AIWS, treating the underlying cause may reduce the severity and frequency of the distorted perceptions. Migraine sufferers may find that following the commonly recommended diet and lifestyle changes may lessen their symptoms.

This article is for information only and not meant to replace your physician's advice.