Alice in Wonderland syndrome

We all remember the disturbing scenes described in Lewis Carrol’s novel and later brought to the big screen. That strange and chaotic world in which the protagonist is immersed is not so far from reality. experienced by those who suffer from Alice in Wonderland syndrome.

It is a rare but alarming neurological disorder, more common among young people and children.. It is characterized by the appearance of brief episodes in which perception is severely distorted. Although people are aware of the illusory nature of their perceptions, the clinical picture can be frightening.

It was the psychiatrist John Todd who related the clinical picture to the popular story and gave it the name it still bears in homage to the author and his work. It is believed that he himself may have suffered alterations in visual perception that he would later transfer to the pages of his story.

What is Alice in Wonderland syndrome?

The main characteristic of this syndrome is the alteration in visual perception and body image.. Objects and parts of the body seem to suddenly change their appearance, generating great confusion and disorientation in the patient.

The affected person observes parts of the body that are of the wrong size, such as a disproportionate head or hands.. Thus, they can appear much larger (macropsia) or smaller than they really are (micropsia). In addition, the size, distance and shape of objects is distorted. Even auditory, tactile and spatial perception can be altered.

Without a doubt, another of the most striking symptoms is the fact that the individual loses the sense of time, which may pass, in their opinion, too slowly or too fast. Some people experience strong hallucinations, visualize elements that are not in the environment, and may show wrong impressions of certain situations.

Characteristics of the clinical picture

It is a low prevalence condition in which children constitute the especially susceptible population. Generally, the syndrome occurs partially, with only some of the alterations described occurring. They usually appear in the form of brief episodes and are benign in nature. (its manifestations are not harmful or dangerous, and may fade over a period of time).

Despite being more common in young people and children, Cases have been described in which the condition has persisted into adulthood. However, the symptoms seem to improve significantly by providing a good night’s rest.

What causes Alice in Wonderland syndrome?

A relationship has been established between this neurological disorder and conditions such as migraine (with and without aura) and epilepsy.. Other risk factors include brain lesions such as tumors or aneurysms and viral infections such as Epstein Barr (acute infectious mononucleosis).

Certain drugs (such as topiramate or risperidone) and drugs (such as LSD, ecstasy or marijuana) also seem to be related to the appearance of this syndrome. The key seems to be found in certain alterations produced in the electrical activity of the brain.. This causes a change in cerebral blood flow that causes the signals sent from the brain to the eyes to be disturbed, leading to hallucinations, disorientation and altered perception.

Treatment of Alice in Wonderland syndrome

Due to its multiple possible causes, the therapeutic intervention is also different in each case. The syndrome has proven and effective treatment when the origin is migraine. In this case, drugs useful in the prevention of migraine such as anticonvulsants, antidepressants, beta blockers and calcium antagonists would be used.

However, chronic cases are quite difficult to address and must be carried out over time. In the event that the condition was caused by an infectious process, the main guideline would be to treat the same. However, other recommendations such as taking adequate rest or joining a support group can also be useful.

In any case, and although the symptoms may disappear over time or as age increases, it is very necessary to go to a professional. It is essential to carry out a good differential diagnosis with other types of similar disorders, in order to implement adequate treatment.

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