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"Alice in Wonderland" is a popular story about a young girl who frequently experienced metamorphic changes in herself and in her environment. These changes included changes in size, distortions in her physical surroundings, distortions in time, and other unusual experiences involving her perceptions and emotions. Her story is not unique, in that some doctors have reported that young patients have experienced what they now call the Alice in Wonderland Syndrome (AWS).

AWS was first reported in 1955 by a British psychiatrist named Dr. John Todd, who noted that some of his patients who suffered from severe migraine headaches also experienced various distortions in perception that were similar to those described in the fairy tale. The symptoms of the condition include:

  • Visual distortions that make things seem smaller or bigger than they really are; things may also appear to be nearer or farther away from the person
  • Body distortions, which make one feel that their bodies, or part of their bodies, have shrank or enlarged
  • Time distortions, which make things seem to move faster or slower - these may include sensations of hearing words being spoken faster or slower
  • Distortions in perception of sound, texture, taste, smell, or position
  • Other emotional experiences, such as fright
  • Visual and auditory hallucinations

Patients usually do not have any previous history of head trauma, psychiatric disorder, epilepsy, drug use, or other disorders of the nervous system.

One study involving 20 patients with ages ranging from four to 16 years, reported that most of the children experienced multiple episodes which lasted for a few minutes each day. The researchers reported that most of these cases were related to a viral infection and migraines in others, although some were due to toxins or epilepsy. Some scientists believe there is a genetic component involved, especially in those who experience migraines. There are very few reports about this condition, but some researchers believe that there may be a lot more patients who do not report or seek consultation for their condition. Not many doctors are aware about the condition, since it is not common, but for those who have examined such patients, many believe that it is a benign (not serious) condition that is probably a variant of migraines. Imaging tests of the brain appear normal, although some patients show some electrophysiological changes, which suggest the possibility of seizures (epilepsy).

In most cases, the symptoms of AWS resolve spontaneously without treatment, although in some, the symptoms persist, while others develop migraines. There is no specific treatment for AWS, but some have tried using pain killers, beta-blockers, and anti-epileptic drugs for the migraines. Stress management is also important, since stress is a common trigger factor for most people who experience migraine attacks. Living a healthy lifestyle, using relaxation techniques, avoiding fatigue, reducing environmental noise and avoiding bright lights may be helpful.

Some authors suggest that more studies should be done in patients who exhibit symptoms of AWS to rule out organic or psychiatric causes, which may need specific treatment.

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