- Diseases, Disorders & Conditions
Alice in Wonderland Syndrome (AIWS) and Migraines
Alice In Wonderland Syndrome is not heard of often when it comes to thinking about migraines. Although its affects can be quite disturbing and definitely disorientating. You may think you fell down the rabbit hole yourself. AIWS is a collection of symptoms and does not occur with migraine exclusively, but it is said Lewis Carrol did suffer from migraines. The name makes it sound almost fun, but really it is just plain bizzare. It did get its name from the novel by Lewis Carrol because of Alice drinking the potion that made her very big and another that made her very small are perceptual affects associated with the condition itself. The condition is also known as Todd’s Syndrome, but that does not sound nearly as memorable because then we could not say we fell down the rabbit hole and are late for tea with the Mad Hatter.
It is believed that AWIS may involve the brain's occipital lobe, which controls our vision and where migraine auras originate. Other regions in the brain may also play a part, but the "exact entrance to the mind’s rabbit hole remains a mystery." (NBC New Health) The syndrome is one that affects our very perceptions of ourselves and our environment. These are separated into a) Distortions in body image called metamorphosis. Where the sizes of various body parts, such as arms, legs or head, are perceived incorrectly. Growing or shrinking in size, although growing does seem to be more common. And b) Visual distortions and perceptions of the world around us. Where the size of objects, or shape of objects, in the environment are perceived incorrectly. Hallways may be too long. The floor too close. Distances may appear incorrect. And the size of people or buildings too large or too small.
The syndrome seems to be more common in children but can re-occur in later life or fizzle out in the teen years. In its most extreme chronic cases it can be very disabling. While sometimes it is experienced before one goes to bed, even in the morning... imagine trying to get through the day with such distortions.
Body Distortions- The distortions is body image can be very strange and disturbing even. The sufferer finds they are uncertain as the size of their entire body or some body part. Stretch of the limbs or expanding or the scull.
Visual Distortions- Visual distortions make it difficult to see the world in a way that makes any sense. Objects appear to be larger (macropsia) or smaller (micropsia) than they should be. It can also mean the entire external world from buildings, to cars and people appear too large or too small and sometimes too close or too far. The walls are too close, the ground it too close. A short street seems too long. Hallways too long with the walls to close.
Perception of texture- There can be a distortion in touch perception as well. The floor with a spongy feel to it when you walk is one example. Or it can be that the sensation you receive from touching something is felt as incorrect or unrecognized.
Time Distortion- There can be a distortion in the perception of time, with it either moving too quickly or two slowly.
Sound Distortion- Sounds can be very aggressive and loud, or very distant sounding and far off. Or muffled and unclear.
Specific tastes and smells
Skewed balance- This might be due the spacial perceptions being distorted so completely such that a person may feel they are standing at an angle to their surroundings, or straight but their surroundings are not straight. It is a very funhouse affect on a persons stability. Another factor here is vertigo. People get that spinning sensation within the head, or external spinning in the environment. Or the sense that they are falling, one foot falling through the floor which makes them stumble. All which affect balance. (However, vertigo is also associated with vestibular migraines.)
There are even some less common symptoms associated with AIWS. Some of which can be hallucinations of solid objects, or auditory hallucinations of voices and music and feelings of unreality. In fact it is said AWIS is likely unreported due to the nature of it seeming to be too bizarre and too close to hallucinations that people feel uncomfortable mentioning it.
Experiences with AIWS
"Floors either curved or dipped, and when I tried walking on them, it felt as though I was staggering on sponges. When I lay in bed and looked at my hands, my fingers stretched off half a mile into the distance. These bizarre episodes were starting to happen more often, but because I was under pressure to finish my degree and get a job, I continued to put them to one side, figuring they must be stress-related or indicative of poor sleeping or diet.I graduated and took a job as a system administrator in a new town, but instead of going away, my symptoms just got worse. Everything was now distorted, all the time. Walking down the road, parked cars appeared the size of Corgi models, while I'd feel disproportionately tall. At work, my chair seemed enormous, while I seemed to have shrunk.Seeing the world through a fisheye lens made day-to-day life very difficult. Unable to judge distances accurately, I would often move clumsily or overcompensate. Soon I found it a struggle to leave the house; I had difficulty correctly perceiving the ground, so walking was tricky. If I didn't think about it I was OK, but as soon as I did, I found myself slumping and struggling to walk in a straight line. Crossing the road began to feel dangerous; when I saw a car coming, I had no idea what size it was, or how far away." (the Guardian)
""quite suddenly objects appear small and distant (teliopsia) or large and close (peliopsia). I feel as I am getting shorter and smaller "shrinking" and also the size of persons are not longer than my index finger (a lilliputian proportion). Sometimes I see the blind in the window or the television getting up and down, or my leg or arm is swinging. I may hear the voices of people quite loud and close or faint and far. Occasionally, I experience attacks of migrainous headache associated with eye redness, flashes of lights and a feeling of giddiness. I am always conscious to the intangible changes in myself and my environment." (Wikipedia)
"I had them myself as a child, but did not know the name for it at the time. When I was trying to fall asleep sometimes it would feel like my arms and legs would stretch out and expand in fluctuating pattern, or that my head was swelling larger or even that if felt like the world was dropping and spinning. Or that I was floating and then falling. It is most common to experience at night. I thought in fact that it was a normal occurrence. I thought everyone had this sort of thing happen before they fell asleep. Like the brain was just giving me these sensations. Because I would check. I would feel my leg and go, if I can feel it then it has not stretched out... it just felt that way. I didn't always like it, mind you, because it stopped me from sleeping often and sometimes it was disturbing. And I had these sensations from somewhere beginning as a child up into my teens. Likely because my migraines began around then to replace it I suppose." (myself mentioning childhood occurrences)
"As an adult with migraine attacks in the morning on waking I would have AIWS. It would often be with time distortions and a great deal of confusion. I would have vertigo with spinning and falling, or just falling and stopping, falling and stopping. When I tried to get up everything was wonky. Objects would be warping, the more I tried to focus on them the more they would shift in shape. Things appeared to move when they should be still. When I walked the floor was like walking on sponges. My sense of balance was always so off I felt drunk. Often the ceiling was too close to me, the walls too close, the ground too close... and looking at them gave me a sense of wrongness because I knew it wasn't right. I'd run my hand along the wall just to walk straight. It always felt so surreal and like I wasn't really able to function right or think properly because it didn't feel real enough. I'd often be late to even call in sick for work because of the skewed perception of time. The vertigo alone made it difficult to just walk and the idea of driving like that terrified me. I often had the the sense things felt wrong... like my face felt swollen but also that the texture was wrong, or my figures were the wrong shape and I would stare at them just positive there was something wrong there. Often since I used my hands just to get around I would notice things felt wrong as well. It was not at all the same experience as when I was a child but I think the acute migraine made a huge difference in that. To be honest I have chronic migraines, with migraine associated vertigo and persistent migraine auras and I there are many days when things were distorted and the vertigo is an issue but the AIWS seems to be like this intense dose of all of that for a longer period of time, with some serious messed up time distortion and sense of unreality tossed in there such that your ability to function is severely compromised. For me when it started to occur as an adult it was definitely tied to the migraines but also apparently to the fact I was getting very little sleep. When the sleep deprivation was treated moderately after a bit I stopped getting these waking bouts of severe AIWS." (myself talking about adult occurrences)
Cause and treatment
People with migraines can get AIWS and it is the more common reason. Other causes can be Epstein-Barr virus, temporal lobe epilepsy or brain tumor. It primarily occurs in childhood and resolves itself. It is rarely seen in adulthood. 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)." (NBC News Health) This is a good indication if you had AIWS symptoms as a child and your child is experiencing the same thing he or she may then develop migraines, or in fact, have migraines as migraines in childhood present differently and it is a good idea to keep this in mind. It in-itself is seen as a benign condition associated with the primary cause, that is it is a collection of symptoms associated with say migraines or epilepsy. That is not to say it cannot be a debilitating condition when it is severe. Chronic cases of AIWS as you might suspect are extremely disabling.
So if you get this you are not going all Mad Hatter crazy, even if feels like you are in a funhouse for a bit. Treatment wise on the migraine side of things is similar treatment to the migraines themselves. A good diet, avoiding trigger foods like wine, chocolate, MSG and nitrates as well as exercising and probably some of the preventatives to treat migraines that effect neurotransmitters might help such as anitconvulsants, antidepressants, beta blocks and calcium channel blockers. Since with migraines we do get quite a few visual disturbances, visual auras, touch disturbances, as well as hearing issues and taste issues, I do recommend we see an eye doctor even if we know it is a migraine aura or it is AIWS, simply because we need to have confirmation it is not something physically going wrong with the eyes themselves rather than neurologically. As well as seeing a neurologist because there is more than one cause for this phenomena so it is best to ensure it is one and not another.
Nevertheless, AIWS is one of the more bizarre and rarely heard of migraine symptoms. However there are symptoms that have similar effects. We do get vertigo, dizziness, and visual disturbances that made this appear to warp or move. Fact is, we can get all sorts of neurological fun when it comes to migraines.
- Alice in Wonderland syndrome - Wikipedia, the free encyclopedia
Alice-in-Wonderland syndrome (AIWS, named after the novel written by Lewis Carroll), also known as Todd's syndrome or lilliputian hallucinations, is a disorienting neurological condition that affects human perception. Sufferers may experience micr
- Experience: I have Alice In Wonderland syndrome | Life and style | The Guardian
Experience: Walking down the road, parked cars appeared the size of Corgi models. At work my chair seemed enormous while I seemed to have shrunk
- Alice In Wonderland Syndrome - The Basics
Alice In Wonderland Syndrome is a rare form of Migraine aura that causes a distortion of body image and perspective, which Migraineurs know is not real.
- Migraine Aura - Alice In Wonderland Syndrome
Alice In Wonderland Syndrome is a rare form of Migraine aura.