Alice in Wonderland Syndrome (AIWS)

Overview

• Also Known As: Todd's Syndrome, Dysmetropsia
• Type: Neurological disorder
• Symptoms: Distortions in visual perception and other senses
• Commonly Seen In: Children, adolescents, and adults
• Onset: Often before, during, or after a migraine

Symptoms

Visual Distortions

• Macropsia: Objects appear larger
• Micropsia: Objects appear smaller
• Pelopsia: Objects appear closer
• Teleopsia: Objects appear further away
• Metamorphopsia: Altered perception of shape
• Tachysensia: Altered perception of time

Other Symptoms

• Impaired vision
• Paranoia from sound perception disturbances
• Altered sense of hearing and time
• Depersonalization-derealization disorder
• Emotional instability, nausea, dizziness

Causes and Theories

• Unknown Cause: Frequently associated with migraines, head trauma, or viral encephalitis (Epstein-Barr virus)
• Theories: Abnormal electrical activity causing abnormal blood flow in brain regions processing visual perception
• Genetic and Environmental Factors: Speculated genetic component; environmental influences like drug use

Diagnosis and Challenges

• Challenges: No established diagnostic criteria, often misdiagnosed
• Diagnosis: Based on ruling out other causes; involves EEG, MRI, and viral antibody detection
• Differential Diagnosis: Distinguishing from other disorders with hallucinations

Treatment

• Current State: No standardized treatment; symptoms often benign
• Approach: Focus on treating underlying conditions (e.g., migraines, epilepsy)
• Medications: Anticonvulsants, migraine prophylaxis, antivirals, antibiotics

Historical Context

• Origin of Name: Inspired by Lewis Carroll's novel, where Alice experiences size and spatial distortions
• Discovery: Described by Dr. John Todd in 1955, but symptoms were noted earlier in WWI and WWII soldiers
• Popular Culture: Featured in TV shows and literature

Epidemiology

• Prevalence: Unknown due to lack of diagnostic criteria and awareness
• Demographics: More common in children and young adults, potentially hereditary
• Gender Differences: Varies with age; higher prevalence in young males and older females

Research and Future Directions

• Current Research: Focus on global collaboration to better understand AIWS and its epidemiology
• Speculations: Connection with temporal lobe epilepsy, hallucinogenic experiences