People suffering from the syndrome experience instances in which items and even sections of their own bodies appear considerably smaller or larger than they actually are. The Pioneer’s Tejal Sinha speaks to experts and brings you a detailed report on the syndrome.
There are numerous rumours swirling around the renowned fantasy series, Alice in Wonderland. Rumours include that the author was under the influence of illegal narcotics (such as opium) while writing the novel and that something very evil was going on behind all the whimsy. Which of those rumours, however, are true?
But hey, we are not discussing the series, but a syndrome named Alice in Wonderland syndrome. Alice in Wonderland is a neurological ailment that is so uncommon that even neurologists, even those who specialise in the disorders, share that it frequently co-occurs with others, such as migraine and epilepsy, and can see patients for decades without ever encountering it.
People suffering from the syndrome experience instances in which items and even
sections of their own bodies appear considerably smaller or larger than they actually are. John Todd, an English physician, originally characterised Alice in Wonderland syndrome in 1952 and named it in 1955.
According to Dr. Pranati Prabhu, a paediatric neurologist, “This is a pretty rare syndrome. But according to some pieces of information available online, the illness is predominantly diagnosed in youngsters, which may be attributable, at least in part, to adults’ reticence to identify the distortions they see. This is only speculation, but some adults may be frightened that others will believe they are insane since what they are experiencing sounds like a hallucination.”
However, in some cases, it is not only an external object that appears to alter size; patients suffering from Alice in Wonderland syndrome may view their own body parts as deformed, either much larger or much smaller. Understandably, people may be concerned about what is creating these perceptions, especially if they are experiencing AIWS for the first time.
People who continue to have episodes may eventually find it more mysterious than terrifying; however, this depends on the individual’s nature.
For the unaware, Lewis Carroll, who wrote Alice’s Adventures in Wonderland, says that it’s probable that his own migraine experience inspired his writing. In the story, Alice discovers a bottle labelled “Drink me,” and when she drinks it, she shrinks to less than a foot tall. Almost immediately after, she eats a cake, which causes her to grow extremely tall until her head meets the ceiling.
Suman Rai, a psychiatrist, shares, “It turns out that the author Lewis Carroll probably had migraines based on some of his diary entries. It’s been speculated that he may have had Alice in Wonderland syndrome himself, which may have contributed to some of the odd aspects in the film.”
According to experts, when Alice in Wonderland syndrome occurs during migraine, it may be caused by the parieto-occipital region of the brain. The parietal area has to do with perception of the body and perception of space, and the occipital area has to do with vision. When it comes to epilepsy, AIWS appears to start in the frontal lobe, but there’s still a lot to understand about it.
The syndrome is so uncommon that many professionals may never see it in their careers.
Although specialists believe that it is uncommon, the overall prevalence is unknown. To date, no epidemiological studies have been conducted to determine the prevalence of AIWS in the general population. Some may avoid discussing their symptoms for fear of being misdiagnosed as hallucinating or suffering from a mental condition. “I believe it most commonly occurs as part of the aura, but it can also occur during the headache. And, as with other migraine aura episodes, the perception changes caused by Alice in Wonderland syndrome may occur without any headache at all,” she shares.
Apart from migraine, there are additional illnesses related to Alice in Wonderland syndrome.
This includes temporal epilepsy as well as some diseases — viral infections like mono or the flu.
According to the Centres for Disease Control and Prevention (CDC), the Epstein-Barr virus (EBV), a kind of herpesvirus and one of the most common human viruses, is the most common cause of mono. It affects the majority of people at some point in their lives. In rare situations, EBV can develop complications such as encephalitis (brain swelling), which is frequently the cause of AIWS in children.
Alice in Wonderland syndrome is a rare symptom of a stroke or brain tumour. That’s really unusual, and you’d generally have a slew of other symptoms in addition to the visual symptoms of the Alice in Wonderland condition. Certain substances, such as LSD or other hallucinogens, can potentially cause AIWS. And there are definitely psychiatric disorders in which such misperceptions are part of the symptoms.
The treatment the experts share is determined by the cause of the visual disturbance; for example, if it is a migraine, we would use migraine medication. If you suffer migraines frequently, you should take preventive medication as well as acute migraine treatment as needed.
