Alice in Wonderland Syndrome (also known as Todd's syndrome,[1] or lilliputian

hallucinations) is a disorienting neurological condition that affects human perception. People

experience micropsia, macropsia, pelopsia, teleopsia, or size distortion of other sensory
modalities. It is often associated with migraines, brain tumors, and the use of psychoactive drugs.
It can also be the initial symptom of the EpsteinBarr virus (see mononucleosis).[2]
Anecdotal reports suggest that the symptoms are fairly common in childhood,[citation needed] with
many people growing out of them in their teens. It appears that AiWS is also a common
experience at sleep onset, and has been known to commonly arise due to a lack of sleep. AiWS
can be caused by abnormal amounts of electrical activity causing abnormal blood flow in the
parts of the brain that process visual perception and texture.[3]

Contents

1 Signs and symptoms

o 1.1 Comparison with Alice's Adventures in Wonderland
o 1.2 Comparison with Gulliver's Travels

2 Diagnosis

3 Prognosis

4 Epidemiology

5 History

6 See also

7 References

Signs and symptoms

The hallmark sign of Alice in Wonderland syndrome (AIWS) is a migraine, and AIWS may in
part be caused by the migraine. AIWS affects the sense of vision, sensation, touch, and hearing,
as well as one's own body image.[4]
A prominent and often disturbing symptom are experiences of altered body image. The person
may find that they are confused as to the size and shape of parts of (or all of) their body. They
may feel as though their body is expanding or getting smaller. Alice in Wonderland syndrome
also involves perceptual distortions of the size or shape of objects. Other possible causes and

signs of the syndrome include migraines, use of hallucinogenic drugs, and infectious
mononucleosis.[5]
Patients with certain neurological diseases have experienced similar visual hallucinations.[6]
These hallucinations are called "Lilliputian," which means that objects appear either smaller or
larger than they actually are.[7]
Patients may experience either micropsia or macropsia. Micropsia is an abnormal visual
condition, usually occurring in the context of visual hallucination, in which affected persons see
objects as being smaller than those objects actually are.[8] Macropsia is a condition where the
individual sees everything larger than it actually is.[9]
A relationship between the syndrome and mononucleosis has been suggested.[10]
One 17-year-old male described his odd symptoms. He said, "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." [11]
The eyes themselves are normal, but the person will often 'see' objects as the incorrect size,
shape or perspective angle. Therefore, people, cars, buildings, houses, animals, trees,
environments, etc., look smaller or larger than they should be, or that distances look incorrect;
for example a corridor may appear to be very long, or the ground may appear too close.
The person affected by Alice in Wonderland Syndrome may also lose the sense of time, a
problem similar to the lack of spatial perspective. In other words, time seems to pass very slowly,
akin to an LSD experience. The lack of time, and space, perspective leads to a distorted sense of
velocity. For example, one could be inching along ever so slowly in reality, yet it would seem as
if one were sprinting uncontrollably along a moving walkway, leading to severe, overwhelming
disorientation. This can then cause the person to feel as if movement, even within his or her own
home, is futile.
In addition, some people may, in conjunction with a high fever, experience more intense and
overt hallucinations, seeing things that are not there and misinterpreting events and situations.
Other minor or less common symptoms may include loss of limb control and general discoordination, memory loss, lingering touch and sound sensations, and emotional experiences.