Alice in Wonderland syndrome is a brain-related condition that disrupts how you perceive your own body, the world around you or both. Named for a famous children’s storybook, this rare condition makes things look or feel larger or smaller than they actually are. It can happen for several reasons, many temporary or treatable.
Alice in Wonderland syndrome (AIWS) is a rare condition that disrupts your brain’s ability to process sensory input. The disruption affects how you perceive the size of things you see around you, the feel or look of your own body, or both. It can also distort your sense of reality.
AIWS seems most common in children, with some research studies indicating that nearly two-thirds of cases happen in people under age 18. In addition to children, AIWS is more likely to happen in people with certain brain-related conditions.
AIWS seems to be rare. That’s partly because there’s limited research on how often it happens. Some available research indicates that up to 30% of teenagers experience brief episodes of AIWS symptoms, but more research is necessary to determine if this is the case and why it’s happening.
One of the reasons why there’s so little available research on AIWS is that it’s almost always temporary. Many of the conditions that cause it are also short-lived, so the effects of AIWS don’t last long. From 1955 to 2016, fewer than 200 cases lasted long enough and were serious enough to need direct medical attention.
Experts also disagree about the exact criteria and symptoms for the condition. Currently, there are no accepted criteria for AIWS, so healthcare providers will often use their professional judgment to decide whether or not to diagnose it. Because of all these factors, experts believe this condition is commonly underdiagnosed or misdiagnosed.
Most experts organize the symptoms of AIWS into different types. While none of the types directly affect your body, one type can affect how your body feels or looks to you. That’s because AIWS seems to disrupt your brain’s ability to monitor your body for potential problems and changes.
The three types of symptoms break down as follows:
The symptoms that can happen with AIWS break down into two categories: self-perception symptoms or visual perception symptoms. People can also have both kinds of symptoms, but visual perception symptoms are much more common.
Your brain monitors and manages your body’s functions. This is extremely important, as it keeps you safe and healthy. However, it’s also possible for something to go wrong with that ability, which is what happens with self-perceptive symptoms of AIWS. They include:
The most common symptoms of AIWS affect visual perception. That means the symptoms affect the way you see things around you. They include:
Experts don’t know exactly why AIWS happens, but they do know there are many conditions and circumstances that can cause it. The possible causes include, but aren’t limited to:
AIWS isn’t contagious. While it can happen with infections that can spread between people (like the flu), these aren’t the only cause.
Unfortunately, there’s no way to diagnose AIWS conclusively. That’s because the condition is rare and usually short-lived, so there are no official criteria for it. The most likely way a provider will diagnose this condition is by asking you questions about the symptoms you have. They’ll also perform a neurological exam to determine if you’re having any issues with other types of brain function. They may also recommend certain types of diagnostic tests to look for or rule out other brain-related conditions — some of which are serious — that could cause AIWS symptoms.
The most likely tests with AIWS include the following. These include:
The most common way to treat AIWS is by treating whatever’s causing it. Because of that, there are a vast number of treatments that might help with AIWS. Your healthcare provider is the best person to recommend treatments that might help. They can tailor that information to your specific condition, needs and circumstances. They can also advise you on the possible side effects or complications you might have and what you can do to limit or prevent them.
Because AIWS can happen with serious (or even life-threatening) conditions that affect your brain, you shouldn’t try to self-diagnose or treat it on your own.
The time it takes to feel better or recover from the symptoms of AIWS depends on the underlying cause and the treatments you receive (if you received any). Your healthcare provider is the best person to tell you the most likely timeline for you related to AIWS.
AIWS happens unpredictably and for reasons that experts still don’t fully understand. Because of that, it’s impossible to prevent it. Many of the conditions that cause it aren’t preventable, and there are limited (or no) ways to reduce your chances of developing AIWS. Fortunately, this condition is also rare, and when it does happen, it’s usually temporary and goes away quickly.
If you have AIWS, you can expect changes in how you perceive your body, the world around you or both. These changes may be disturbing or even scary the first time they happen. However, this condition isn’t usually dangerous on its own.
While AIWS isn’t usually dangerous, you shouldn’t ignore the symptoms. That’s because AIWS could be happening due to dangerous conditions like a stroke or brain infection. If you have AIWS that only lasts a short while and goes away before you can get medical attention, you should still talk to a healthcare provider as soon as possible.
If you have AIWS along with stroke symptoms, you should get emergency medical care immediately. You should also get immediate medical care if you have a fever or other symptoms of brain- or nervous system-related infections. These include:
AIWS can last for different spans of time, depending on what causes it. It’s usually temporary, and episodes of AIWS may only last minutes or hours with many of the most common causes. However, other factors and conditions can make it last longer. Your healthcare provider is the best person to tell you how long this condition is likely to last for you and what — if anything — you can do to shorten or stop the symptoms.
AIWS on its own is rarely dangerous, and there are very few cases where AIWS needs direct medical care. However, it can happen with dangerous conditions, and the outlook for these cases can vary widely. Your healthcare provider is the best person to tell you the likely outlook for your case and what you should expect.
For most people, managing the underlying condition can help reduce the severity of AIWS symptoms and how often they happen. For others, AIWS is a temporary effect of a condition that’s curable or goes away on its own.
If you have recurring episodes of AIWS related to a chronic condition like migraines or seizures, your healthcare provider is the best person to tell you what you can do to limit or manage AIWS symptoms. They can guide you on lifestyle changes or preventive and precautionary measures you can take to limit the effects of AIWS.
You should get immediate medical care if you’ve never had AIWS symptoms before. That’s because AIWS is itself a possible symptom of medical conditions that are severe, dangerous or life-threatening. If you have a history of AIWS and a diagnosed chronic condition that can cause it, your healthcare provider is the best person to tell you the symptoms or warning signs that mean you need immediate medical attention.
No, AIWS and schizophrenia are separate conditions. AIWS can happen in people with schizophrenia, but this isn’t common. There are also many other conditions and circumstances besides schizophrenia that can cause a person to develop AIWS symptoms.
AIWS was first described and named in 1955 by a psychiatrist from England named John Todd. Todd named this condition for the main character of the 1865 storybook “Alice’s Adventures in Wonderland” by Lewis Carroll. In reality, Lewis Carroll was a pen name for English mathematician and writer Charles Dodgson.
In the book “Alice’s Adventures in Wonderland,” Alice encounters situations where the size of objects, creatures and even herself are distorted. Alice is, at times, incredibly tiny. At other times, Alice grows and is a giant towering over others.
More than a century after Dodgson’s death, medical experts suspect some of what Dodgson wrote about in “Alice’s Adventures in Wonderland” was based on symptoms he was experiencing. Writings from his diary may also support this, as Dodgson described some symptoms that would fit with conditions that can cause AIWS. However, because Dodgson died in 1898, there’s no way to know for certain if he truly had AIWS himself.
A note from Cleveland Clinic
Alice in Wonderland syndrome (AIWS) is a rare condition that happens because of disruptions in how your brain processes your perceptions of your own body or the world around you. That can make parts of your body — or your whole body — feel or look smaller or larger than usual. It can also make things you see around you look smaller or larger, or change where they appear to be in relation to you. Most cases of AIWS are temporary and short-lived. However, having these symptoms — especially if you’ve never had them before — can still be a disturbing or even scary experience.
You shouldn’t ignore AIWS symptoms. While experts still don’t fully understand AIWS, it’s often possible to treat, or even cure, the underlying cause. That means this already-rare condition is usually just a temporary concern for most people who have it.
Last reviewed by a Cleveland Clinic medical professional on 12/05/2022.
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