What is Alice in Wonderland Syndrome?

People with Alice in Wonderland syndrome have episodes where objects and even parts of their own body can appear much smaller or much larger than they really are. The Alice in Wonderland syndrome was first described in 1952 and named in 1955 by John Todd, an English psychiatrist, one of the strangest and most curious syndromes in the world.

This condition occurs mostly in children, although this may be at least in part because adults are unwilling to describe the distortions they see, says Dr. Annette E. Grefe, a pediatric neurologist at Wake Forest Baptist Health in Winston. -Salem, North Carolina.

The following explains what Alice in Wonderland syndrome is like, as well as its diagnosis and treatment.

THINGS APPEAR MUCH LARGER OR MUCH SMALLER THAN THEY REALLY ARE

According to Dr. Anjan K. Chatterjee, a neurologist at Penn Medicine in Philadelphia, people with vision withdrawal report perceiving changes in their environment. " Typically, a seizure includes micropsia, in which objects appear small, or macropsia, in which things appear larger than they really are," says Dr. Chatterjee.

In some cases, it's not just an external object that appears to change size; People experiencing Alice in Wonderland syndrome may perceive their own body parts in a distorted way, either much larger or much smaller.

“ These episodes can last for minutes and sometimes longer—it's not quick—or it's a two-second thing where you rub your eyes and everything is better,” says Chatterjee.

It is understandable that people may have some anxiety and fear about the cause of these perceptions, especially when experiencing AIWS for the first time. For people who continue to have episodes, over time it can be more disconcerting than frightening, but it depends on the personality of the individual, Chatterjee says.

LEWIS CARROLL HIMSELF COULD HAVE HAD AIWS

Lewis Carroll (pseudonym of Charles Lutwidge Dodgson) was the author of Alice's Adventures in Wonderland and may have been influenced by his own migraine experience in writing the book.

In the book, Alicia finds a bottle labeled "Drink Me," and when she does, she shrinks to less than afoot. Almost immediately after, she consumes a cake that makes her grow very tall until her head hits the ceiling.

" It turns out that author Lewis Carroll probably had a migraine, based on some of his diary entries, " says Chatterjee. There has been speculation that he himself experienced Alice in Wonderland syndrome, and that may have been part of the origin of some of those unusual parts in those stories, he says.

THE AIWS CAN AFFECT HOW A PERSON PERCEIVES

• the view
• the ear
• the touch
• the feeling
• time

The most common visual distortions are micropsia, in which the person sees objects smaller than they are, and teleopsia, in which objects appear to be farther away than they really are.

There are three main categories of AIWS, which differ depending on the type of perception disorder.

The categories are:

• Type A, in which the disorders are somesthetic or sensory
• Type B, which affects the visual senses
• Type C, which is a mix of types A and B

The authors of a 2016 article state that type A follows the original AIWS definition, which implies that people feel as if their body parts change size.

A PERSON WITH AIWS TYPE B MAY EXPERIENCE

• Micropsia, in which objects appear too small
• Macropsia, in which objects appear too large
• Metamorphopsia, in which aspects of shapes, such as height and width, seem inaccurate
• Pelopsia, in which objects appear too close
• Teleopsia, in which objects appear to be farther away than they are.

A person with AIWS type C may perceive that both their own body image and that of other people or things around them change. According to a 2012 study, there are more cases of type B in young individuals and more cases of type C in adults.

TREATMENT AND MANAGEMENT

TREATMENT OF AIWS DEPENDS ON THE UNDERLYING CAUSE.

If migraine is the source of the condition, doctors may suggest migraine control through diet and preventative medication. However, if epilepsy is the cause of the symptoms, the doctor may prescribe anti-epileptics. If an infection is to blame, they may offer antiviral agents.

According to a 2016 systematic review, doctors rarely prescribe antipsychotics because, despite the nature of the syndrome, there is no psychosis in AIWS. Antipsychotics can also increase the chances of epileptic activity, possibly worsening the person's condition.

DIAGNOSIS

There are no formally established criteria for diagnosing AIWS, and the range of potential symptoms is wide.

When AIWS is diagnosed, the doctor reviews the symptoms the person is experiencing in a way that makes them feel comfortable.

The doctor can then look for the causes of each symptom and assess how they are related to each other.

TESTS TO DIAGNOSE AIWS MAY INCLUDE

• Neurological and psychiatric consultation to assess mental status
• Routine blood tests
• MRI to obtain an image of the brain
• Electroencephalography (EEG), which evaluates the electrical activity of the brain and can help doctors identify epilepsy
• Additional evaluations

WHEN TO GO TO THE DOCTOR?

A person should seek medical attention if they experience any of the above symptoms, even if the episodes are brief. A doctor may find an underlying cause that was previously unclear. Identifying a cause will make it easier to reduce the severity of symptoms.

 

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