Alice in Wonderland Syndrome: What You Should Know About Visual Migraines

The highly acclaimed children’s author, Lewis Carroll, experienced severe migraines in his childhood and all through adulthood, according to his journals. His symptoms may have been the inspiration behind the big-and-small effects seen in Alice’s Wonderland. In this post, I’ll go over everything I know about this rare neurological condition of visual migraines. 

What is Alice in Wonderland Syndrome?

Also called Todd syndrome for the English psychiatrist who coined the term, at its core, Alice in Wonderland Syndrome is a disturbance to perception, and it can be quite disorienting. The condition is characterized by altering your sensory perceptions, so it can affect how you interpret things you see, hear, feel, and touch. It can also affect how you perceive time. 

The condition affects mostly children and young adults, and most patients outgrow the symptoms; however, adults can still be affected. Like migraines on their own, visual migraines in the form of AIWS have little research to help us determine the disease’s natural tendencies and behaviors. AIWS can present in multiple ways, including:

·         Migraines with aura, especially visual disturbances

·         Sensory distortion in terms of size and perception

·         Time distortion

·         Loss of coordination or limb control

Symptoms of Alice in Wonderland Syndrome

There are five main symptoms of Alice in Wonderland syndrome. 

1.       Microspia is seeing objects as much smaller than you.

2.       Macropsia is seeing objects as much bigger than you.

3.       Teleopsia is a misperception of distance – like seeing someone right next to you when they’re across the room.

4.       Metamorphopsia is a distorted view of the height and width of shapes.

5.       Pelopsia is when all objects and people appear to be too close to you.

More specific symptoms include:

·         Distorted body image

·         Fever

·         Severe migraine attacks

·         Seizures that are epileptic and only affect a single part of the brain.

Most people who experience these symptoms know what they’re seeing isn’t real, but they still see them as 100% accurate. 

AIWS Types

Dr. Todd identified three main types of Alice in Wonderland syndrome:

·         Type A is defined as sensory and affects those who feel like they are changing size, rather than objects changing. 

·         Type B, the most common, is defined as a distorted environment, like those five primary symptoms discussed above.

·         Type C is a mix of types A and B.

Causes of Alice in Wonderland Syndrome

We don’t know a lot about this syndrome yet, but many migraine practitioners believe the cause can be one or a combination of a few things, including:

·         Abnormal blood flow to the brain causing electrical disturbances

·         Chronic infections, as seen in this study from 2014 (likely the leading cause in children)

·         Migraines and head trauma (probably the leading cause in adults)

·         Chronic stress

·         Stroke

·         Epilepsy

·         Brain lesions or tumor

·         Overuse of medications

·         Psychiatric illness

·         Drug use (hallucinogens)

We know so little about this condition other than how to recognize symptoms. Treatments are far more challenging to determine, especially since it appears that many outgrow symptoms. Right now, your best course of action would be to avoid medications and rest when an episode occurs to let it pass. Remind yourself or your loved one that it’s okay not to have the answer yet. If you rest and don’t drive or operate machinery, the symptoms are harmless, albeit uncomfortable. Focusing on treating the underlying condition, and you will likely address this problem in the process.

Remember, you aren’t alone in this journey. Medical science is an evolving practice, especially in terms of helping the body heal itself safely. If you have questions or would like to discuss a few ideas for treating Alice in Wonderland Syndrome, don’t hesitate to reach out. I help people all around the world find their best regimens for addressing migraines.  


Healthline: What Is Alice in Wonderland Syndrome? (AWS)

Neurology.Org: Alice in Wonderland Syndrome: Presenting and Follow-up Characteristics

Medical News Today: AIWS

Lifey Health on YouTube: Alice in Wonderland Syndrome: 10 Interesting Facts