Alice in Wonderland Syndrome

Caused by a disturbance of perception rather than an actual physiological change
Altered body image (Ex: big buildings look same size as person’s own body)
Distorted perception of size (micropsia, macropsia)
Distorted perception of the shape of objects
Loss of spatial perspective (sense of time and space)
Auditory or tactile hallucinations

AIWS generally affects a younger population and has several associated conditions. Migraine is the classic disease linked to AIWS, the distorted sensations can either begin before a migraine (aura or “warning”) or afterwards, and in younger patients can even occur without headache

Check out these first-hand accounts of people with this interesting phenomenon:
Size Matters: Living in a Lewis Carroll ‘Wonderland’ – ABC News

When the world looks like a real-life Wonderland

Experience: I have Alice In Wonderland syndrome 

A Not So Pleasant Fairy Tale: Investigating Alice in Wonderland Syndrome | Serendip Studio

Other causes of Alice in Wonderland Syndrome are:
psychoactive drugs
infectious mononucleosis
malignancy
temporal lobe epilepsy

Certain tests & imaging studies help rule out secondary causes:
urine toxicology screen
monospot test   
(for mononucleosis)
MRI brain
with and without contrast (to look for malignancy)
EEG   
(to detect seizures or seizure-like activity)

Sounds scary, right? Well, good news is it’s not as bad as it sounds. Most patients who experience AIWS as children will outgrow the condition as adults. Patients should be monitored for worsening of symptom severity and frequency. If all studies are negative and the patient continues to improve clinically, then further evaluation and/or treatment is not needed. Best management for future attacks is focused on migraine prophylaxis and lifestyle modifications (healthy diet, regular exercise, adequate sleep).

Posted By Sidra Ghafoor, Drexel University College of Medicine Class of 2013

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8 thoughts on “Alice in Wonderland Syndrome

  1. My 5 year old son had Mono in September/October and seemed to recover OK. This week he just got over a horrible stomach bug but seems to have recovered from it, too. This afternoon he started complaining of everything seeming like it is far away. I am wondering if AIWS can be caused my Mono that he had months ago or if it only happens at the time you have Mono? Can it also be caused by dehydration? Worrying about AIWS being a symptom of Brain Tumor/Stroke but do not want to overreact. Will be calling the doctor tomorrow but am worrying. Any help you could provide would be great! Thanks in advance!

  2. My 16 year old daughter was just diagnosed with AIWS by a neurologist, she had Mono in January and has a family history of migraines, epilepsy, and cancer. We are trying to reduce the effects of it by trying to figure out the triggers. So far we have had little luck but have noticed that certain types of music might be a factor, particularly the organ music at church. We would love to join a legitimate support group or discussion group about AIWS. Is there such a thing?

  3. My 10 year old son has been experiencing nightly episodes of Aiws for the last month and now is getting them during the day. When he’s outside in the fresh air and light he’s fine but as soon as he comes inside it seems to start. More commonly at night but becoming more frequent during the day. He sees things far away then has the feeling (not visually) that they are coming back at him and will hit his head. The only thing that helps is sitting someone quiet and staring at an iPad and not diverting his eyes. We have tried deep breathing but I’m wondering if there are other ideas on how to get through them especially as it’s now happening at school.

  4. I’ve found myself at this page through a google search as my sister, my nieces and myself were discussing this condition without me knowing it’s name and I described my experience as being like Alice in Wonderland because of the feeling of ‘growing’ while the cars at the side of the road stayed the same size. My niece then told me she’d been diagnosed with it and it’s apparently quite rare. At that point her sister and my sister joined the conversation to admit we’d all experienced similar things! Only one of my nieces has been diagnosed with epilepsy, and I have migraine with aura but the other two don’t have migraine or epilepsy. We’re confused about the fact it’s described as rare and yet two sets of sisters in the same family have it.

  5. This is very interesting to me. I experienced these episodes as a child, and have not had an episode since I was a teenager. I am now 30 years old. What is interesting is that I had completely forgotten about this until today when my 6 year old daughter had her first episode. I believe hers was brought on by a fever, she has strep throat, but I’m also wondering if there is any link in genetics. I have tried finding any research that has been conducted on this topic, but I’m not having much luck. I’m so intrigued by this now that my daughter has had an episode, I would like to find out more information on any genetic link. If you could point me in the right direction, I would greatly appreciate it:)

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