Alice in Wonderland syndrome

Alice in Wonderland syndrome (AIWS), also known as Todd's syndrome or dysmetropsia, is a neurological disorder that distorts perception. People with this syndrome may experience distortions in their visual perception of objects, such as appearing smaller (micropsia) or larger (macropsia), or appearing to be closer (pelopsia) or farther (teleopsia) than they are. Distortion may also occur for senses other than vision.

Alice in Wonderland syndrome
Other namesTodd's syndrome, Lilliputian hallucinations, dysmetropsia
The perception a person can have due to micropsia, a potential symptom of dysmetropsia. From Lewis Carroll's 1865 novel Alice's Adventures in Wonderland
SpecialtyPsychiatry, neurology
Symptoms
  • Macropsia - Objects are perceived larger than their actual size
  • Micropsia - Objects are perceived smaller than their actual size
  • Pelopsia - Objects are perceived nearer than they actually are
  • Teleopsia - Objects are perceived much further away than they are
  • Metamorphopsia - Altered perception of shape
  • Tachysensia - Altered perception of time
ComplicationsImpaired vision
Usual onsetBefore, during, or after a migraine
DurationEach symptom is separate and will only occur for a 20-to-50-minute period.

The cause of Alice in Wonderland syndrome is currently unknown, but it has often been associated with migraines, head trauma, or viral encephalitis caused by Epstein–Barr virus infection. It is also theorized that AIWS can be caused by abnormal amounts of electrical activity, resulting in abnormal blood flow in the parts of the brain that process visual perception and texture.

Although there are cases of Alice in Wonderland syndrome in both adolescents and adults, it is most commonly seen in children.

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