Alice in Wonderland Syndrome

 

Low-angle shot of a stylized mirror and tea table

Alice in Wonderland syndrome (AIWS) is a form of sensory disturbance. The most common symptoms are micropsia and macropsia, which causes objects to appear much smaller or larger than they truly are. For example, a chair may appear half of its typical size. However, AIWS can distort one’s sense of touch or hearing as well.

Alice in Wonderland syndrome is named after Lewis Carroll’s book Alice’s Adventures in Wonderland. In the story, the protagonist shrinks down to the size of a mouse, then later on grows larger than a house. Some researchers have hypothesized that Lewis Carroll himself may have had AIWS.

Symptoms of Alice in Wonderland Syndrome

Alice in Wonderland syndrome causes temporary distortions in perception. Most episodes only last a few minutes. Although the symptoms may feel disorienting or confusing, they are generally harmless.

There are 58 recognized symptoms of AIWS, although most only appear in a handful of cases. Some of the most common symptoms are:

  • Micropsia: Objects appear much smaller than they really are.
  • Macropsia: Objects appear much larger than they are in real life.
  • Teleopsia: Objects seem further away than they are.
  • Pelopsia: Objects seem closer than they are.
  • Dysmorphopsia: Straight lines or edges appear to be wavy.
  • Macrosomatognosia: A person’s own body feels much larger than it is. (Microsomatognosia is when one’s body feels smaller.)
  • Quick-motion phenomenon: Time seems to go much quicker than it really is, as if the surrounding world is on fast-forward. This could manifest as objects appearing to rush around or as voices talking too quickly.

Alice in Wonderland syndrome is not a sign of psychosis. Unlike a hallucination, which often causes people to see things which aren’t there, AIWS causes people to see a skewed version of their present environment. The affected individual generally knows that what they are seeing is strange or unreal. AIWS is a neurological issue, not a mental health diagnosis.

What Causes Alice in Wonderland Syndrome?

There are many factors that can cause Alice in Wonderland syndrome.

  • Migraines: A 2016 literature review estimates 27% of AIWS cases co-occur with migraines. Some researchers theorize that AIWS is a rare type of migraine aura, which is a sensory warning of an oncoming migraine.
  • Infection: Around 23% of AIWS cases seem to be caused by infections, the most common being the Epstein-Barr virus. Infections can cause parts of the brain to swell, which affects cognitive functioning.
  • Head Trauma: Injuries to the brain cause 8% of AIWS cases. When damage occurs in the parts of the brain that combine and interpret sensory information, a person can get distorted vision or have trouble sensing their own body.
  • Epilepsy: Around 3% of AIWS cases may be caused by epilepsy.
  • Medications or drugs: Certain medicines, especially cough medicines, may cause AIWS symptoms. Hallucinogenic drugs have also been implicated in some cases.

Around one in five cases of AIWS have no obvious cause.

Most cases of Alice in Wonderland syndrome (65%) occur in children. The mean age of onset is 8 and a half years. Most individuals grow out of the syndrome with age. Around one-third of cases have persistent symptoms, and these cases often co-occur with migraines.

Alice in Wonderland Syndrome Treatment

There has not been much research on Alice in Wonderland syndrome. Since the symptoms aren’t dangerous and only last a few minutes, many cases go unreported. It is exceedingly rare for researchers to be able to observe AIWS symptoms as they occur.

There is no test to diagnose Alice in Wonderland syndrome. Instead, clinicians will work backwards, ruling out other potential causes of the symptoms. For example, a doctor may order blood tests done in order to diagnose any viruses in the person’s body. MRI scans may be used to examine the brain.

Treatment for Alice in Wonderland syndrome usually addresses the underlying causes. For example, if a person’s symptoms are caused by migraines, anti-migraine medication can help reduce symptoms. When stress exacerbates AIWS symptoms, meditation and relaxation techniques can help individuals cope. However, most cases of Alice in Wonderland syndrome will disappear with time.

References:

  1. Blom, J.D. (2010). A dictionary of hallucinations. New York, NY: Springer.
  2. Blom, J. D. (2016) Alice in Wonderland syndrome: A systematic review. Neurology Clinical Practice, 6(3), 259-270. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909520
  3. Liu, G., Liu, A. Liu, J., & Liu G. (2014, April 29). Alice in Wonderland syndrome: Presenting and follow-up characteristics (S19.003). Neurology. Retrieved from https://n.neurology.org/content/82/10_Supplement/S19.003
  4. Mastria, G., Mancini, V., Vigano, A., & Di Piero, V. (2016). BioMed Research International. Retrieved from https://doi.org/10.1155/2016/8243145
  5. Stapinski, H. (2014, June 23). I had Alice in Wonderland Syndrome. The New York Times. Retrieved from https://well.blogs.nytimes.com/2014/06/23/alice-in-wonderland-syndrome
  6. What is Alice in Wonderland syndrome (AWS)? (n.d.). Healthline. Retrieved from https://www.healthline.com/health/alice-in-wonderland-syndrome

Last Updated: 04-25-2019

  • 10 comments
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  • Andrew

    Andrew

    July 2nd, 2019 at 11:47 PM

    I just want to know if this is some what common, i was trying to go to sleep and it was very unsettling , i had a feeling that i could not shake as if i was a very much smaller version of myself inside a very much bigger version of myself trying to control it much like someone in a exoskeleton suit but difficult , like my arms were much harder to move and my breathing/heart rate were not addiquite for the larger body and i felt trapped

  • Alicia

    Alicia

    December 19th, 2019 at 11:32 PM

    Are there any studies going on at the minute? I used to experience this quite often as a child, less and less as an adult but still occasionally. I would be really interested to know what’s going on…

  • Marie

    Marie

    January 27th, 2020 at 2:42 AM

    I have experienced this all my life. Had much more as a child and teenager. Less frequent naw. At the age of 41 years. My daughter age 7 has recently experiencing this and they are lasting around 40 minuets to an hr everyday. It’s under investigation.

  • hallie

    hallie

    February 26th, 2020 at 10:57 PM

    thank you so much for posting this. I used to experience this as a young child (5 or so) until the age of 15, with it getting less and less frequent. It was something that always scared me so much and I didn’t know how to explain to anyone and it would often happen while i lay in bed trying to fall asleep in a dark room.

  • Amber

    Amber

    March 19th, 2020 at 9:45 PM

    omg im so glad to have found this page. i never knew there was a name for this, or that other people experienced it. it was always something that i had kept to myself since i was little, but it was always a horrible experience for me and it would end in panic attacks and anxiety. luckily i havent had an episode in forever..

  • Lisa

    Lisa

    June 11th, 2020 at 11:17 PM

    My daughter is currently going thru what seems to be this. She said it is such an uncomfortable feeling, more and more “episodes” everyday. Some have her in tears because it feels so uncomfortable. I wish there was a test or treatment to get rid of it.

  • Joan

    Joan

    July 8th, 2020 at 3:59 PM

    I used to experience micropsia when I was younger. It was usually when I was tired, often at night when I was reading. The writing would become smaller and smaller, as would everything in the room. Even when I closed my eyes I still had a strange sensation, and images in my head were small. I’m in my 70s now, and haven’t had it for years, though I do sometimes get that strange feeling that it’s going to happen, but doesn’t.

  • Kyle

    Kyle

    July 20th, 2020 at 12:14 AM

    I used to experience Macropsia almost conatantly when I was a kid. Never knew what it was. I still do as an adult(just less). Infact, that’s why I’m here, I’m currently having an episode as I type. It started while I was in bed so o googled it. Its super uncomfortable and gives a feeling in between anxious and panic. All the while my little Galaxy S7 looks the size of a damn Ipad+ or something.

  • Jean

    Jean

    July 24th, 2020 at 2:54 PM

    I have recently, well a few months before Covid, diagnosed with AIWS and I wish my episodes only lasted a few minutes. I literally have to lay down as it seems the world around me is growing, shrinking, and rolling all around me. As my body seems to get heavier a migraine grows my vision than become blurry and I normally have a seizure afterwards. It’s the worst feeling in the world. Even worse is the inability to afford the anti seizure medications, that stopped doing patient assistance in 2017. So I am on lockdown, also have fibromyalgia so I’m in constant pain, and unable to so many things. If there were more resources and studies done it sure would help with people like me who feel lost and confused. I have a psychiatrist and primary doctor but just those visits along along with my general bills, affording prescriptions is far from being in a reasonable budget. I have lost out on work that I can do since my children are home, I have bad days and very bad days more often thanks to the stress of everything. AIWS may not be a dangerous neurological issue but it can have dangerous effects with a persons emotions and make them feel like they will never get out of the rabbit hole they are in. Pun intended.

  • VS

    VS

    July 29th, 2020 at 1:07 PM

    Hello everyone – so I just found out I had this syndrome when I was a child. I was ironically watching a paranormal show and a child described the symptoms of things getting larger and closer. So I looked up vison disturbances and finally put a name to the experience I had as a child. I don’t have it anymore but I have migraines several times a week for which I am on medication. I believe from what I’m reading that this syndrome can precede onset of migraine. I don’t remember having migraines that young (like 8) but it was but a few years after the migraines started. It was scary and as a child I didn’t know what was going on. Telling my parents didn’t go anywhere. Now I will speak to my children and grandchildren and brothers and sisters and see if anyone else has had this experience. So sorry for those who are still trying to manage with this as adults.

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