Alice in Wonderland Syndrome

Alice in Wonderland Syndrome (AIWS) is a neuropsychological condition that is very rare. It is also called Todd’s syndrome or dysmetropsia. It is a condition that causes temporary distortion in perception and disorientation. They may experience distortions in visual perception of objects either appearing smaller ( micropsia) or larger ( macropsia) or appearing closer ( pelopsia) or farther away ( teleopsia). They are caused by changes in how your brain perceives the surroundings you are a part of and how your body looks.

This distortion can happen besides vision as well. It affects multiple senses such as vision, touch, and hearing. One may also lose a sense of time. This is often associated with Migraines, brain tumours, and psychoactive drugs. They are not caused due to an eye problem or hallucination. These episodes happen most commonly in children and young adults. It can affect people of all ages. Almost around one-third of sufferers continue to experience ongoing episodes.

It can be caused by an irregular amount of electrical activity which results in abnormal blood flow in parts of the brain that process visual perception and texture. It is seen that at least 10% of the population may experience these effects at least once in their lifetime.

 

SYMPTOMS

AIWS  episodes vary for each individual. A typical episode lasts five to twenty minutes.

The common symptoms are 

1. Migraines

This is the most occurring symptom. Some researchers believe that AIWS is actually an aura. Others believe that it may be a rare subtype of migraine.

2. Nausea

3. Dizziness

4. Size distortion

Micropsia and Macropsia are experienced during an episode of AIWS. Micropsia is the sensation that your body or the objects in your surrounding are growing smaller. Macropsia is the sensation that your body or the objects in your surroundings are growing larger.

5. Perceptual distortion

Pelopsia and teleopsia are experienced during an episode. Pelopsia is the sensation that objects are closer than they really are and teleopsia is the sensation that objects are moving further apart in your surroundings.

6. Time distortion

They might lose a sense of time. They may either feel the time is passing by really fast or slower than it really is.

 

Less frequent symptoms

1. Memory loss

2. Lingering touch

3. Emotional instability

4. Sound sensation  – Every sound seems typically loud and intrusive.

5. Loss of limb control or loss of coordination – This symptom occurs when muscles feel as if they’re not in your control. One may feel uncoordinated or have difficulty in moving than they normally would.

 

CAUSES 

It is not clear what causes AIWS but they do know that AIWS is not a problem related to the eye or hallucination or mental illness. They believe unusual electric activity may be the result of many causes. They found that 33% of people with AIWS experienced infections. Head trauma and migraines were around 6%. But most of the causes are unknown. Migraine is considered a leading cause of AWS in adults. Infection is considered as the primary cause. Other possible causes are:

1. Stress

2. Cough

3. Use of hallucinogenic drugs

4. Epilepsy

5. Stroke

6. Brain tumour

 

RISK FACTORS

These may increase the risk for AIWS –

1. Migraines –  AIWS may be a type of aura or sensory warning of coming migraine.

2. Infections – AIWS may be an early symptom of the Epstein Bar Virus ( EBV). This can cause infectious mononucleosis.

2. Genetics – If one has a family history of migraines and AIWS, there is a higher risk of experiencing this condition.

 

DIAGNOSIS

Your doctor may be able to diagnose by ruling out other possible symptoms and causes. These episodes may happen several times a day or several days in a row.

1. MRI scan – It produces a highly detailed image of your organs and tissues, including the brain.

2. Electroencephalography ( EEG) – It measures the electrical activity of the brain.

3. Blood tests – Doctors can rule out viruses or infections that cause AWS symptoms like EBV.

 

TREATMENTS

There is no treatment for AIWS. The best way to handle it is to rest.  It is important to reassure that the symptoms are not harmful. Treating the underlying cause of AIWS may prevent future episodes. Medication and relaxation can help reduce symptoms.

 

COMPLICATIONS 

AIWS gets better over time. The syndrome may disappear entirely as you reach adulthood. It hardly causes any complications or problems. Almost around a third of people without a history of migraines developed them after experiencing AWIS.

 

HELPLINE

1. National Health Helpline – 1800-180-1104

 

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