What is AiWS?
Alice in Wonderland Land Syndrome (AiWS), also known as Todd syndrome (after a Psychiatrist, John Todd, discovered it in the 1950s) or dysmetropsia, is a rare neuropsychological condition characterized by visual and non-visual distortion or alteration in visual perception of oneself or the surrounding environment.
It was named thus as the observed symptoms were portrayed in Lewis Carroll’s 1865 legendary fantasy book, ‘Adventures of Alice in Wonderland’. It is also said that Carroll himself had this Syndrome, which on the long run birthed the book.
An individual experiencing AiWS sees the surrounding environment in a different way from what it is in reality; his perception appears to be the opposite of reality.
Alice in Wonderland Syndrome often occur in relatively short episodes that averagely lasts between five to thirty minutes, and in rare cases, up to two days or more. It occurs mainly in children and adolescents (this can be due to the structural differences in their brain, compared to that of an adult and in some cases, wears off as they grow older), however it is present in some adults.
An AiWS patient can experience various forms of distortions but some common alterations that can pass for AiWS are as follows;
Macropsia/Micropsia – when an individual sees objects to be larger/smaller than their original sizes respectively.
Teleopsia/Pelopsia – objects appear farther/closer than their normal position respectively.
Achachromatopsia – inability to perceive colour.
Dysmorphosia – in this case, lines and contours appear to be wavy although straight in their real forms.
Seeing rough surfaces as smooth and vice versa.
Seeing straight standing objects as inverted or rotated.
Partial/total macro/micro-matognosia – part of the body (the entire body in some cases) appears larger or smaller than it is.
Alteration in the judgement of time – they perceive the time to be faster or slower than usual.
Sound distortion – every sound, even typically quiet sounds, seems loud and disturbing.
Loss of coordination – the muscles seem to act involuntarily.
Depersonalisation/derealisation – a feeling of disconnection from one’s body, feelings, thoughts and environment.
AiWS patients may experience one or more of these distortions in a single episode.
AiWS and hallucination.
AiWS is different from hallucination; in the latter, the individual experiences or feels them as real while the reverse is the case in the former. Although the experience is quite vivid, the individual knows that what they see and feel is not real.
What are the causes of AiWS?
Over time, there is no known cause of this Syndrome. This is mostly due to the rarity of this disorder. Also, occurring mostly in adolescents and below, very few cases are reported for fear of being tagged as a mental patient, thereby, accounting for the unknown cause in more than half of the affected population.
However, some underlying conditions have been observed to possibly (though still unclear) cause AiWS; they are as follows:
Migraine: Migraine is considered the leading cause of AiWS (though its role in AiWS is still unclear and open to more research). Typical migraine symptoms (aura, visual derangements, hemi-cranial headache, nausea and vomiting) are also symptoms that are associated with AiWS. Migraines is said to cause AiWS in adults more than any other cause.
Cerebral hypotheses: Researchers have shown that the high/unusual amount of electrical activities in the brain can cause an abnormal flow of blood in parts of the brain that process and experience visual perception and texture of the environment.
Infections: this is considered to be the leading cause of AiWS in children and adolescents.
Encephalitis: this is the inflammation of the brain, characterised by headache, fever, confusion, stiff neck, vomiting and reduction or alteration in consciousness.
Other possible causes can include any of the following;
Use of psychoactive drugs
Can AiWS be treated?
Currently, there is no treatment for AiWS. Symptoms of AiWS tend to disappear on their own after some time, especially in children and adolescents (as they grow up). Also, underlying symptoms of AiWS, such as migraine, infections etc, can be treated to prevent episodes of AiWS from happening. If an individual’s symptom was diagnosed to be Hypnotic Stress, appropriate rest should be prescribed.
Do AiWS patients risk future health challenges?
Several conditions have been discovered to be aftermaths of AiWS;
Migraines in some individuals is believed to be an after effect of AiWS.
AiWS in some children is believed to be an initial stage of the Epstein-Barr Virus (EBV), which can cause mononucleosis (an infection usually caused by the Epstein–Barr virus, EBV, that is mostly spread through saliva. Symptoms may include fever, sore throat, enlarged lymph nodes in the neck, and tiredness. It is common mostly in children and teens).
Individuals that have experienced AiWS stand the risk of passing it on to their next generation.
From a general view, AiWS episodes can happen several times in a day and could disappear for some weeks or month.
While AiWS symptoms could be overwhelming, it is worthy to note that they are neither harmful nor a sign for more serious problems.
Do well to visit your doctor if you experience any of the symptoms associated with AiWS.
Post credit: Jeremiah