Alice in Wonderland Syndrome (AIWS) is a temporary perceptual disturbance. A child with AIWS may experience temporary visual distortions like the character from the book Alice’s Adventures in Wonderland: a feeling that their whole body is suddenly larger or smaller, or that their surroundings have suddenly shrunk or become giant. They can also experience perceptual distortions of any of the other senses: taste, sight, hearing, or sound. Some children may also experience distortion in the perception of time, feeling as though they are moving impossibly quickly but, in fact, are barely moving at all. The syndrome is thought to have a genetic component, as it often runs in families.
Though frightening and disorienting for a child, AIWS episodes are temporary, and most children eventually grow out of their episodes. The syndrome is also referred to as Todd’s syndrome, after the British psychiatrist who identified it in the 1950s. Lewis Carroll, the author of Alice’s Adventures in Wonderland, suffered from migraines and is thought to have based the surreal events of the book on his episodes of the syndrome.
AIWS is a symptom of an underlying neurological disturbance rather than a disorder in of itself. These perceptual distortions may be caused by sudden abnormal neural activity or a rush of blood in an area of the brain. AIWS episodes may, in fact, be a type of aura that may precede or accompany a seizure or migraine headache.
Finding the underlying cause of AIWS episodes in children is essential for effective management of the syndrome. The most common cause in children is migraine headaches, temporal lobe epilepsy, or infection. A clinician will typically order an MRI, EEG (to detect unusual electrical brain activity) and blood tests to help determine the underlying condition.