Journal of Rare Disorders: Diagnosis & Therapy

Commentary

Alice in Wonderland syndrome (AIWS) is a rare neurological disorder characterized by distortions of visual perception (metamorphopsias), the body image, and the experience of time, along with derealization and depersonalization. You may also find that the room you’re in — or the surrounding furniture — seems to shift and feel further away or closer than it really is. They’re caused by changes in how your brain perceives the environment you’re in and how your body looks. AIWS primarily affects children and young adults [1].

Categories

Type A: Type A follows the original definition of AIWS, which involves people feeling as though their body parts are changing size.

Type B: Type B affects visual senses.

Type C: A person with Type C AIWS can perceive both the image of their own body and that of other people or things around them to be changing.

Causes

The most common causes of AIWS appear to be migraines and Epstein-Barr virus infections. Other causes may include: brain lesions, medication, psychiatric conditions, epilepsy, stroke. Brain tumors may cause temporary AIWS. Head trauma may also be a possible cause.

Risk Factors

Several conditions are linked to AWS. The following may increase your risk for it:

• Migraines

• Infections

• Genetics

Symptoms

The symptoms of AIWS depend on its type and the person it affects.

They includes: distorted body image, altered perception of time, metamorphopsia, distorted perception of size, feverish symptoms, migraine episodes and epileptic seizures that affect only part of the brain, sound distortion, loss of limb control or loss of coordination [2].

Diagnosis

When diagnosing AIWS, the doctor reviews the symptoms that the person is experiencing in a manner that helps them feel comfortable.

Tests for diagnosing AIWS may include:

• neurological and psychiatric consultation to assess mental status

• routine blood testing

• MRI scans to provide an image of the brain

• electroencephalography (EEG), which tests electrical activity in the brain and can help doctors identify epilepsy

• additional assessments

Treatment

There’s no treatment for AIWS. Treating what you and your doctor suspect is the underlying cause for AWS episodes may help prevent an episode. For example, if you experience migraines, treating them may prevent future episodes.

Long-Term Outlook

While the symptoms can be disorienting, they aren’t harmful. They’re also not a sign of a more serious problem. AWS episodes can happen several times a day for several days in a row, and then you may not experience symptoms for several weeks or months [3].

References

1. https://www.healthline.com/health/alice-in-wonderlandsyndrome#risk-factorshttps://www.webmd.com/children/ureacycle-disorders
2. https://www.medicalnewstoday.com/articles/alice-in-wonderlandsyndrome#symptoms
3. https://www.frontiersin.org/articles/10.3389/fneur.2019.00473/full