Alice in Wonderland Syndrome

Ordinary people with superpowers into giants or dwarfs is one of the usual plots of many fairy tales and animation works, such as the use of shape-shifters into Ultraman, which is also one of the many wild imaginations of children.

In reality, the Ames room uses the background to cause the optical illusion, a small way to satisfy people's fantasies.

Ames room

However, for some children and even adults, the enlargement or shrinking of the body or objects in the external environment is not new but rather distresses them.

Sometimes they may feel that an object or part of their body is suddenly enlarging or shrinking, or is slowly moving away from them. Sometimes the illusion that time is flying by and that the sounds around you are very noisy can also occur.

This is similar to the hallucinations that many people experience when they have a fever and is often seen as the person's imagination. It can be a neuropsychological disorder that causes distorted perceptions, which we now call "Alice in Wonderland syndrome (AIWS)". Yes, it is Alice in Disney, adapted from the children's literature published in 1865 "Alice in Wonderland".

In the story, Alice dreamed that she followed a white rabbit and fell into a strange world. Here, a sip of water can shrink to the size of a mouse, eat a piece of cake, and will become a giant, the same mushroom to eat the right side will become shorter, eat its left side will grow taller. She also met the weird twin brothers, crazy crazy hatter and March Hare, which led to a lot of jokes and strange encounters.

The film becomes smaller Alice through the rabbit hole into the fantasy world

Many people have fantasized about being able to enter a wonderful wonderland like Alice, and some even spent years trying to create a similar garden, which now seems not entirely whimsical.

For Alice in Wonderland syndrome patients, that "Wonderland" there is no castle with smiley flowers, no Mad Hatter and March Hare, only everything that does not fit the usual size.

It is hard to imagine that behind such a beautiful name lies a mysterious disease. Someone once described feeling his tongue swell up like a cow's tongue during an attack, and the wall farthest from him in the room began to slowly recede, eventually turning into a tiny white square floating in the distance. When looking back at the book in his hand, he found that the words on the book were much enlarged.

The first person to link the two together was British neurologist John Todd, who first named it "Alice in Wonderland Syndrome" in an article published in the Canadian Medical Association Journal in 1955.

The five adults and one adolescent mentioned in Todd's article had all experienced hallucinations of irrational changes in their bodies or external environment, some of whom recalled it as a sensation of "the body expanding or contracting or splitting in half in a closed space.

Todd's inspiration for the name came from patients, and not his own - he coined the term while citing a 1952 paper by Carlo W. Lippmann.

Lippman recorded the "hallucinations" of seven patients, the first of whom said she felt "about a foot tall" when she gazed at herself in the mirror.

And the sixth patient said, "My head is like a balloon, I pull it down from the ceiling, exhausted."

Two other patients sometimes felt that their bodies had become short and wide. One of the patients referred to this feeling as "Tweeden or Tweedy-like. Tweedledum and Tweedledee are the diminutive twins depicted in Alice in Wonderland, the sequel to Alice in Wonderland.

Tweeden and Tweedie

This made Todd think of the similarity between the experiences of these patients and the suddenly large and small Alice, whose patients experienced changes in body size and strange sensory distortions just like Alice. So Todd followed the fairy tale scenario and named the collection of symptoms "Alice in Wonderland Syndrome".

Patients with AIWS have a distorted perception of size, resulting in symptoms such as small and large objects, i.e., they sometimes see external objects or parts of their body that are smaller or larger than normal, which is the most common symptom of Alice in Wonderland syndrome.

In addition to this, the patient may also have errors in distance perception, with distant vision and near-front hallucinations. For example, a corridor may seem long or the ground may seem too close. And sometimes they may experience "visual breakdowns," a mosaic of visual effects in front of their eyes.

In some cases, the AIWS patient's sense of touch and hearing may also be distorted. They may feel like they are sinking into the floor or walking through walls. Patients are also often paranoid due to sound perception disorders, where they hear sounds louder, softer, closer, or farther away. The condition can be disorienting and sometimes frightening.

One 17-year-old boy described his strange symptoms this way: "All of a sudden, objects become small and far away, and some become large and close. I feel myself getting shorter and smaller, and I see people no bigger than my index finger. Sometimes I could also see curtains or TV sets swaying up and down, or see my legs or arms swinging. I can hear people's voices very loud, very close, very faint, and very far away. I am always aware of invisible changes in myself and my environment."

People affected by Alice in Wonderland syndrome sometimes also lose their sense of time and sometimes feel that time passes very slowly. The dissonance between the sense of time and space can in turn lead to a distorted sense of speed. For example, a person moving slowly, in reality, may appear to the sufferer as if a person is running uncontrollably on a moving sidewalk.

So what exactly causes Alice in Wonderland syndrome? Todd noted that these patients did not have brain tumors, impaired vision or mental illnesses - conditions that can cause similar symptoms. The patients were all able to think clearly and to distinguish between hallucinations and reality; it was just that their perceptions were distorted.

Lippmann and Todd found through their study of patient histories that these hallucinations could be related to migraines, epilepsy, or a combination of these disorders. As early as 1913, the German-Jewish neurologist Hermann Oppenheim noticed that one of his patients who suffered from migraines exhibited such symptoms.

Interestingly many researchers, including Lippmann, suspected that Lewis Carroll, the author of Alice in Wonderland, had been affected by migraines and had hallucinated such a thing, writing the next hugely popular fairy tale.

Lewis Carroll

In 1856, Carroll consulted William Bowman, a famous ophthalmologist, about visual impairment in his right eye. He also recorded in his diary his 1856 experience with "bilious headaches" and visual disturbances. And nine years later, he completed Alice in Wonderland.

Another fictional plot similar to AIWS can be found in Jonathan Swift's novel Gulliver's Travels, in which the main character, Gulliver, ends up on an island where the land of the little people is located. Therefore, Alice in Wonderland syndrome is sometimes referred to as the "small vision syndrome".

Mental illnesses such as Alice in Wonderland syndrome can indeed inspire some creators. It is thought that this illness also affected the 20th-century German artist Kesui Kollerwitz, who is considered to be the most important graphic artist of the early 20th century and a symbol of resistance to oppression.

As a result, Kollwitz's artistic style shifted from realistic naturalism to expressionism, which expressed emotion through distorted imagery.

Jesus Collehuizi

In her diary, Collehuizen describes a situation in her childhood when her senses were distorted. She complained that there were times when objects seemed to be getting bigger or smaller, and she seemed to be getting smaller, which was frightening. There were also times when she felt like she was in a room with no air, or felt like she was sinking or disappearing.

So many people speculate that what plagues her may be Alice in Wonderland syndrome and that she may still suffer as an adult, though she keeps it a secret. Many patients will keep secrets to avoid being labeled as mentally ill.

This seems a reasonable assumption since Alice in Wonderland Syndrome was not named and widely publicized until 10 years after the death of Coleridge.

Woodcut from the series "War", "Sacrifice

This may also explain why the subjects of her art are often shaped with large hands and faces. The distortion presented in her visual art may have less to do with the artist's deliberate emphasis on sensation and more to do with her perceptual experience.

For most people, however, Alice in Wonderland syndrome is more psychologically stressful, with patients experiencing these "hallucinations" many times a day, and more frequently after sunset.

Most patients describe their symptoms as lasting between 10 seconds and 10 minutes, with some becoming frightened, scared, and panicked throughout the hallucination, and those affected may even harm themselves or others around them.

Although Alice in Wonderland syndrome can affect people of all ages, it commonly occurs in early childhood, and most sufferers outgrow these symptoms as they get older. Perhaps because the symptoms are usually harmless and disappear on their own, the patient does not require medication or surgery, and few parents take their children to the doctor because of their "out-of-this-world" fantasies, there has not been much concern.

Interestingly, many studies have shown that one parent of a child with Alice in Wonderland syndrome tends to have similar symptoms in early childhood, showing certain family traits.

However, so far researchers have not found the exact cause of this very rare brain disease, which has some relationship with many diseases, such as the first discovered migraines, epilepsy, and o, and their conditions, and some studies have shown that it is related to an EBV encephalitis that can cause infectious mononucleosis.

So there are no very effective treatment options, and you can only wait for it to go away naturally.

As one of the top 10 rare diseases in the world, Alice in Wonderland syndrome may be more common than we think. A study of 3,224 adolescents in Japan showed that 6.5% and 7.3% of boys had visual macrosomia and visual microsomia, respectively.

We know that both of these symptoms are manifestations of Alice in Wonderland syndrome, but of course some neurological disorders can also cause such symptoms. In the absence of well-established diagnostic criteria, it is sometimes necessary to determine whether a patient has Alice in Wonderland syndrome by exclusion.

Although Alice in Wonderland syndrome has been around for a long time, it remains a mystery. But as Children's Hospital of Philadelphia pediatric neuro-ophthalmologist Grant T. Liu and neurologist Owen Pickrell believe, the medical community will become increasingly interested in it.

Whether it's to explore this mysterious condition or to find out how it relates to other diseases, some of them are certainly drawn to the name "Alice in Wonderland Syndrome.

"If the initial use of complex and obscure words to name it, there may not be so many people interested in the disease." Liu even thinks so.

This is not without merit. But even if named after a fairy tale, it still belongs to a disease that requires deeper research scientifically.