Alice in Wonderland Syndrome (AIWS)

Alice in Wonderland Syndrome (AIWS) is a rare (~200 cases reported in history) constellation of perceptual disturbances affecting males and females alike with a higher incidence in children. AIWS is marked by distorted body image and metamorphopsia, illusory changes in the form, size, distance, or color of stationary objects.

The etiology of AIWS is an acquired disorder that is believed to develop following an injury to a complex region of the brain known as the temporo-parieto-occipital (TPO) junction. The TPO junction is the site of visual and sensory information process. A trauma to the region, from a variety of factors, may cause its dysfunction resulting in AIWS.

A host of predisposing factors for AIWS are reported including encephalitis (children), migraine (adults), epilepsy, encephalopathy, TBI, brain tumors or lesions, brain aneurysms, psychiatric disorders (schizophrenia, depression, and depersonalization disorder), hallucinogen intoxication (LSD, cocaine, or marijuana), infectious diseases (chickenpox, Epstein Barr virus, H1N1, mono, flu, Lyme disease, scarlet fever, Shigellosis, Typhoid fever, CJD, and some medications.

Many individuals are known to experience only a single type of distortion (either size of objects or distance between objects are altered. Visual distortions -seeing objects smaller or larger than normal, perceiving objects as being closer or farther from each other, inability to differentiate between colors, visual hallucinations, sensing straight lines and edges as wavy, and the inability to judge time.

EEG is not considered to be a useful diagnostic tool for AIWS. Further tests and procedures to diagnose the causative condition may be needed and treating the underlying condition may reduce or eliminate the sensory disturbances. Currently, there are no suitable treatments AIWS.

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