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

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  • 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

    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

    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

    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

    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

    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

    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

    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

    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

    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.

  • Matt

    August 16th, 2020 at 6:28 PM

    I get this all the time, I have it now in fact! I can only just see what I am typing it is so far away. I’m 25 and still not grown out of it. Interesting to kn

  • abinav

    September 12th, 2020 at 9:59 AM

    Thank u so much for this…i used to experience this as a kid and no one used to believe me when i told them what i was experiencing. i was also ridiculed in school many times because people thought i coudn’t read. my parents had also taken me to an opthamolagist and the doctor told my parents i was making it up. it’s such a relief to finally know what it was. :)

  • SRR

    January 7th, 2021 at 6:20 PM

    My son is 10 years old, he is telling us that he is seeing small things. He started saying this a few years ago, so far he told us happening during winter and spring. He says that each episode lasts for about 2 minutes and it happening at least 3 times a day. Should we go take him to the doctor’s? As I read there is no real treatment and he will have to grow out of it. In my family both my wife or myself never had this issue when we were child, little worried any help would help. Thanks.

  • Alicia

    January 13th, 2021 at 1:08 PM

    My son just turned 7 years old and had these episodes last year from January-May and then they completely stopped for the next 7 months. They have now started up again on an every other day basis with no consistency of pattern whatsoever. Day, night, bright or overcast. He has the micropsia version and was diagnosed at Vanderbilt with AIWS. He is an otherwise healthy boy, super active and isn’t scared of the episodes at all, but we as his parents r. We just want to be sure we rnt missing something but reading everyone else’s experiences tells me it might be something he just has to live with. Has anyone found anything that makes them subside?

  • Blake

    February 10th, 2021 at 1:38 PM

    I really think that I have AIWS with Quick-motion phenomenon. It began as a young child (I would say 2nd or 3rd grade.) and has sense calmed down to almost non existent as an adult (32 years). During the episodes I get the feeling that everything around me is moving at a pace so fast it feels as if my movements are in slow motion. Along with this my thoughts are basically screaming in my head and it feels like my fight/flight goes into hyperdrive (almost as if my brain just stepped off of a treadmill?). As a child I use to get so scared when this would happen that I would go hide in a corner until it was over. As an adult I only have to deal with it maybe once or twice a year and have finally realized that I am going to be ok and I just need to ride it out until its over. If anyone else reading this feels these same things I would love to talk about it, when trying to describe it to loved ones they just look at me as if I am crazy.

  • Bat

    April 2nd, 2021 at 10:28 PM

    I had this when I was little (7-8 years old), and still do sometimes, and I can assure you it was probably one of the most terrifying experiences I’ve ever had. Nothing quite compares to feeling as if you are stuck in a disproportionate world. I experienced micropsia, macropsia, teleopsia, dysmorphopsia, and macrosomatognosia. The most vivid memory of this that I have was during the middle of the night. I remember I woke up in the middle of the night and I didn’t know why. I had a bunk bed, but no one slept on the top, and the bottom bunk was where I usually slept. This was the case this time, and I remembered sitting up in bed and feeling very unsettled. My stomach felt kind of heavy and I felt restless, (almost like you do before a presentation or a quiz you haven’t studied for) but it was constant and without any kind of reprieve. I sat up in bed and I remembered feeling too large. The top of the bunk felt too close to me, and my hands felt way too big. If you’ve ever seen old cartoons where they hurt their hands and they show their fingers inflate like balloons, you’ll know what I felt like. I felt very off kilter and, even at the age of eight, I knew that it was very irrational to think that my hands had grown to the size of a 6in by 6in board over the span of a few hours. My head too felt too big too and I remember feeling panicky. Most times when this happened I just sat completely still and took deep breaths and pushed through for however long it lasted. This time, however, it felt impossible. I had a very big and thick blanket to sleep with that night and usually when I felt the blanket between my fingers, it felt heavy and thick, but this time when I grabbed the blankets to try and center myself and “reel myself into reality” the blanket felt like a tissue between both of my hands. I remember getting even more agitated then and folding my big blanket until it couldn’t fold anymore and pressed my palms on opposite sides. But even when I stared down at the distance between my hands (maybe a good 4-5in) I swear I could feel my palms press against each other. At that moment I couldn’t stand how disproportionate everything was anymore. I stood up to try and walk it off, but when I did I stumbled and I realized that the world around me was warped. It felt like staring into a mirror that was slightly bent, or standing too close to a camera and seeing the world bend and shift around you. Or like looking into the ocean and seeing things reflected in distorted ripples. By that time I was so freaked out I decided to go into my living room and turn on the light. It didn’t even occur to me in my confused state to wake up my parents and, even the day after, the situation was so bizarre just to me-the person who actually lived it- that I wasn’t sure they’d believe me. I turned on one lamp and sat on the couch and tried to focus on a single spot on the wall opposite me where there weren’t any lines or different colors that could warp-just plain beige. Even then I could feel everything else around me was wrong, and when I closed my eyes it just made everything worse and made me more aware of my abnormal feeling body. My stomach was still turning and I still felt sick, not to the point where I’d throw up, but enough that it was a constant throb and it left me disoriented. I remember crying at some point because of the confusion and discomfort. At the time I had exited my room, I was sure that everyone was well asleep, and it was no where near morning. What felt like maybe ten minutes later, my older sister (who was in her early twenties at the time) got up and took a shower and changed into her clothes. Now looking back on it I realize that it would be quite irrational for her to wake up at maybe one in the morning take a shower and change clothes. She had seen me on the couch only after walking to the bathroom, exiting it after her shower to change, and then coming back out. I realized I must’ve been quite the sight, curled up with my knees tucked into my chest and staring at the wall. That episode was the last time it happened that bad. I still get it, (I’m in my teens right now) but not nearly as bad. Sometimes when I’m reading, I can see the letters float off of the page toward me and feel my arms stretch away from me too. Now though, I can look away from my page and stare down at my legs for maybe a minute or so and then start reading normally again. I’d say the last time that happened during reading was last week. I also quite frequently experience episodes just as bad as the one I described when I was aged eight, but they are only imaginary. I see things and people warped and scaled down very small and I can see the walls and lines skewed as well. These are very uncomfortable for me still, because no matter how hard I try I can’t change the picture in my head. I could focus on one of those imaginary lines for minutes on end and tell myself to envision it as a straight line, but it will not shift at all. And even if I scrap that picture in my head and try to envision it again, this time straight, it will still be warped. The only consolation I have now is that I can open my eyes and it will go away.

  • Jacob

    April 11th, 2021 at 10:34 AM

    This used to scare the crap out of me as a kid. But for some reason I never told anyone about it. It was like i thought it was just a normal occurrence, or as if I couldn’t explain what was happening and I why I was uncomfortable/scared. The times it occurs has definitely lessened with age, but if I stare at something too long, a book, phone screen, computer screen, it will happen for a few minutes.

  • sof

    April 30th, 2021 at 10:20 AM

    There are more then just Macropsia and Micropsia, because i Experiencing my self “Quick motion Phenomenon” and “Heavyposia” , Heavyposia = the feeling of the object of the object seem heavier than it should be , usually our own Hands and legs, but the feels disappear when you move them, when “Quick motion Phenomenon” occur, i feel the time move fast forward, people talking so fast just like fast forwarding video, i even one time watching my Wall-Clock number moving so fast, i usually doing a big Inhale and exhale when this happen until it’s gone, but much faster back to normal state when i learn to smoke and have smoke a cigarette ,…

  • Carly

    July 17th, 2021 at 6:08 AM

    My 4 year old just started having episodes a few weeks ago saying everything looks very small and she is very panicked & scared when it’s happening. I took her to the pediatrician yesterday, who wants her to be seen by an optomoligist and get blood work done. We will go the avenue to make sure nothing else is causing these episodes but I’m glad to now know about AIWS.

  • Nicole

    August 21st, 2021 at 12:03 AM

    So glad to get some other perspectives on this syndrome. My daughter has been experiencing this for 6 of her 10 years – she’s terrified when it happens and it’s great to have a name for it. I’m taking her to a pediatric neurologist to rule out any worrisome causes. For now I just snuggle her and tell her she’s safe and to remember it will go away in a little bit. Would love any other suggestions from people who had this as a kid and if there was something that made them less scared. I feel so bad for her. :( Does anyone know of any support groups?

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