What is Alice in Wonderland syndrome?
Alice in Wonderland syndrome (AIWS), also known as Todd’s syndrome, is a rare neurological condition that causes disorienting episodes usually characterized by visual disturbances and migraine headaches. Think of Alice’s adventures in Wonderland from the time she falls into the rabbit hole to all her different disorienting experiences. As she’s traveling down the rabbit hole, she starts to see various pieces of furniture floating around her. There are colors pulsating as she looks around. She looks in a mirror and sees a distorted view of herself. Once she lands safely on the floor, she finds a series of doors that seem to get smaller and smaller as she opens them. From there, she continues on her disorienting adventure.
This is how an episode feels for those with AIWS. It’s important to understand that these episodes are not visual hallucinations or illusions. It’s possible that the episodes are due to a change in the electrical activity in parts of the brain that are responsible for processing the way people perceive their surrounding environment.
It’s unfortunate that doctors don’t know the exact cause of this medical condition, but the first reported case occurred in 1955. Since then, most of the cases that have been reported to doctors have been from children. It’s not until the child describes their symptoms that adults start to confess that they once had, or continue to have, those symptoms. It’s possible that it can be hereditary. However, it can also be caused by other conditions. Migraine headaches seem to be the most common cause. While some doctors believe that AIWS is a type of migraine, others believe that it may be a symptom of the condition. Either way, migraines are associated with this condition. Other causes include epilepsy, infections such as Epstein-Barr virus, head trauma, stroke, brain tumor, and even certain medications like cough syrup.
Symptoms of Alice in Wonderland syndrome
The most commonly reported symptoms of AIWS are size and visual perception distortion accompanied by migraines. Some people experience micropsia, which is when they see objects as extremely small. Others experience macropsia, which is when they see objects as extremely large. They may even have a distorted body image because when they look at their own body, they either see it as extremely small or extremely large. They may also see objects closer (pelopsia) or farther (teleopsia) from them than they actually are. Some people may experience flashes of color or see colors pulsating. They may also see straight lines turn wavy. Since these symptoms are often accompanied with migraines, doctors believe that these are auras giving warning that a migraine is coming.
Vision isn’t the only sense that can be affected. Some people can experience sound distortion. Sound can either be really loud or really quiet. It can also be very high pitched or very deep. It can also appear to be sped up or slowed down. Time distortion is another symptom that people with AIWS can experience. People can lose their sense of time and it can appear to be moving faster or slower than normal.
The most concerning symptoms are the loss of coordination or limb control. The altered sense of reality that an episode can bring on can also affect someone’s ability to walk properly or even move around. People may feel uncoordinated or struggle to walk as they normally would. Sometimes it may feel as though they don’t have control over their own muscles and their limbs react involuntarily.
Individuals who experience these symptoms should bring it up with their doctor immediately. Doctors should monitor each time this happens to ensure that it doesn’t get progressively worse. Individuals will probably be referred to a neurologist so that they can run multiple tests. Unfortunately, there isn’t just one test that can diagnose individuals with AIWS. For this reason, multiple tests will have to be run and the doctor will probably have to rule out other medical conditions before landing on Todd’s syndrome.
The doctor will inquire about the symptoms and ask if there’s a history of migraines before jumping into the tests. Some of the tests include:
- A blood test:Blood tests help rule out other medical conditions, but it can also confirm any viruses like Epstein-Barr virus.
- Electroencephalography (EEG): An EEG measures the electrical activity in the brain.
- MRI scan: An MRI takes detailed images of the brain. This will help identify or rule out any brain tumors.
Since this condition is still a bit unknown to doctors, it’s not uncommon for this condition to go undiagnosed. However, persistence is important for a proper diagnosis. Doctors should be taking detailed notes of each visit to keep a record of symptoms.
Treatment for Alice in Wonderland syndrome
Currently, there isn’t a treatment for AIWS. The best course of treatment is to treat the associated condition. If the associated condition is a migraine, then the doctor will work towards treating the migraines. If the associated condition is epilepsy, then the doctor will work on treating epilepsy. The key is to reduce the amount of episodes the individual has to endure. Certain medications may help with this treatment, but doctors may also suggest that individuals change their diet to help reduce migraines or seizures.
While the symptoms have been reported to get better over time, this may not be the case for everyone. Most adults tend not to report the symptoms in adulthood because they’ve been dealing with them since childhood. Some adults have even said that their symptoms embarrassed them because their visual distortions made them feel crazy. So, doctors don’t have a great indication of how many adults still suffer from episodes. This is why adults who continue to experience these symptoms need to make sure to report it to their doctors and keep a record of symptoms.
