Alice in Wonderland syndrome

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Alice in Wonderland Syndrome (AIWS)
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Synonyms Todd's Syndrome, Dysmetropsia
Pronounce N/A
Field Neuropsychology
Symptoms Visual distortions such as micropsia, macropsia, pelopsia, teleopsia; sensory distortions
Complications
Onset Often in childhood, but can occur in adolescents and adults
Duration Varies
Types
Causes Varies, often associated with migraines, infections, and psychiatric conditions
Risks
Diagnosis Based on symptoms and exclusion of other conditions
Differential diagnosis
Prevention
Treatment Varies based on underlying cause
Medication
Prognosis Generally good with treatment of underlying condition
Frequency Rare
Deaths N/A


Alice in Wonderland Syndrome (AIWS), also known as Todd's syndrome or dysmetropsia, is a rare neuropsychological condition characterized by perceptual distortions. People with this condition may experience distortions in the visual perception of objects, such as seeing objects as being smaller (micropsia) or larger (macropsia) than they actually are. Perceived distances can also be distorted, with objects appearing closer (pelopsia) or farther away (teleopsia) than reality. Distortions can also occur for senses other than vision. AIWS most commonly affects children, but there have been documented cases in adolescents and adults as well.[1]

Symptoms[edit | edit source]

The hallmark symptoms of AIWS are perceptual distortions. These can include:

  • Micropsia: Objects appear smaller than they actually are.
  • Macropsia: Objects appear larger than they actually are.
  • Pelopsia: Objects appear closer than they actually are.
  • Teleopsia: Objects appear farther away than they actually are.

In addition to visual distortions, some people with AIWS may experience distortions of other senses, such as hearing or touch.[2]

Causes[edit | edit source]

The exact causes of AIWS are not fully understood. It is often associated with migraines, infections (like the Epstein-Barr virus), and psychiatric conditions such as depersonalization disorder.[3]

Diagnosis[edit | edit source]

Diagnosis of AIWS is primarily based on the patient's symptoms and the exclusion of other potential conditions. There is no specific diagnostic test for AIWS.

Treatment[edit | edit source]

Treatment for AIWS generally involves addressing the underlying cause, such as treating migraines, infections, or psychiatric conditions. In some cases, the symptoms of AIWS may resolve on their own.[4]

Prognosis[edit | edit source]

The prognosis for individuals with AIWS is generally good. While the perceptual distortions can be distressing, they are typically not harmful and do not lead to other health problems. With appropriate treatment of the underlying cause, the symptoms of AIWS often resolve.[5]

Epidemiology[edit | edit source]

AIWS is a rare condition, but the exact prevalence is unknown due to underdiagnosis. It is most commonly diagnosed in children, but it can also occur in adolescents and adults.[6]

History[edit | edit source]

AIWS was first described by the British psychiatrist John Todd in the 1950s. The name "Alice in Wonderland Syndrome" was coined because the perceptual distortions experienced by people with this condition are reminiscent of the surreal events in Lewis Carroll's novel "Alice's Adventures in Wonderland".

See also[edit | edit source]

Migraine Perception Depersonalization disorder

Alice in Wonderland syndrome Resources
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Contributors: Prab R. Tumpati, MD