ALICE IN WONDERLAND SYNDROME

     Alice was really in Wonderland, sometimes she was seeing small things, sometimes they were much bigger than her, but people with Alice in Wonderland Syndrome look too small and too big whatever the object is. For example, they see their own house with size of their dog’s house, they can see a bird big as dinosaur, etc. This perception disorder is a result of change in perception as opposed to the eyes themselves malfunctioning. 
  A rare form of migraine, Alice in Wonderland Syndrome causes people to see their own bodies or those of others or everyday objects askew. It typically occurs without a headache, but is usually associated with personal or family history of standard migraines. It can  impact vision (size or depth), hearing, touch and sense of time, causing it either to seem accelerated or or slowed down.


The syndrome was first described in 1955 by the English psychiatrist John Todd (1914-1987). Todd named it, of course, for Alice's Adventures in Wonderland by Lewis Carroll. Perhaps not coincidentally, Lewis Carroll suffered from severe migraine. Also known as a Lilliputian hallucination.


"It's not dangerous," says headache expert Dr. William Young. "I've never met anybody who has so many that it affects their life in a severe way, once they're reassured that it doesn't indicate a dangerous or ominous thing."


Young, a neurologist from the Jefferson Headache Center at the Thomas Jefferson University in Philadelphia, says millions of Americans have typical migraine aura. "We know their brains are normal, superficially."   But, "periodically, they misbehave," he says.


Auras, visual sensations which precede a migraine, can be triggered by stress, certain foods and wine and typically last from five to 60 minutes. The triggers of Alice in Wonderland Syndrome are lesser understood, but certain prescribed medications including migraine-preventing topiramate or a hard blow to the head can set it off.


Experts believe Alice in Wonderland Syndrome is probably underreported because patients  are reluctant to talk about their odd experiences. About 300 in the U.S. have the condition, Young estimates. It mostly occurs in children. Among the thousands of headache patients Young has seen, only four have the syndrome.

"My [Alice in Wonderland] patients have the perception of things being wrong," Young says. "The original descriptions were their own bodies being out of whack."

Dr. Kathy Lee, a pediatric ophthalmologist from Boise, Idaho, says her young patients with the condition often complain about the chalkboard at school being too far away (teleopsia), which may lead to a wasted trip to the eye doctor.

"It's not an eye problem, per se. It's a brain interpretation of vision," says Lee, who often just assures parents that their kids will be fine. "These (images) are generated by the brain, not the eyes."

Treating an episode of Alice in Wonderland syndrome may be like trying to catch a harried rabbit. But medications used to prevent migraines may provide help for those with frequent episodes, Young says.

While children with Alice in Wonderland syndrome may grow out of it into regular migraines, Young says symptoms may warrant a check up for less common but more serious conditions, including epilepsy, brain tumors and encephalitis (brain infection).