Neurosurgery and Brain Health Scary But True: Alice in Wonderland Syndrome By Neurosurgery, October 25, 2016 Alice in Wonderland Syndrome (AWS), also known as Todd’s syndrome or Lilliputian hallucinations, is a condition in which visual perception is altered. This altered state can cause objects to appear smaller, bigger, closer, or farther away than they really are. It is believed that at least 10 percent of the population experiences these effects at least once in their lifetime. Alice in Wonderland Syndrome Symptoms There are several symptoms of AWS, but none of them occur simultaneously. Each symptom is separate and will only occur for a five-to-20-minute period of time. Unfortunately, each of these symptoms can also be the result of a completely different issue. Micropsia (in which objects appear smaller than normal) Teleopsia (in which objects appear further away than they actually are) Macropsia (in which objects appear larger than normal) Metamorphopsia (in which straight lines appear wavy, warped, or blank) Pelopsia (in which objects appear nearer than they actually are) Some believe that hallucinations, time loss, and seizures are also part of AWS; however, others argue that these symptoms are instead generated from the original condition that causes AWS. Alice in Wonderland Syndrome Causes AWS occurs for such a short amount of time, which makes it difficult for doctors to find the cause. According to the National Center for Biotechnology Information (NCBI) the following are direct causes of AWS: Head trauma Migraines Infection Brain tumors Acute Disseminated Encephalomyelitis Alice in Wonderland Syndrome Treatment There is no treatment for Alice in Wonderland Syndrome. The best way to treat this condition is simply by helping the patient become more comfortable. For example, if the problem is caused by migraines, the treatment of the migraine itself may be the best way to alleviate Alice in Wonderland Syndrome symptoms. A migraine prophylaxis followed by a migraine diet is the most common attempt at treatment, but this “fix” may or may not help with AWS. AWS mainly occurs in children and, in most cases, goes away over time. For more information, visit the UPMC Neurology Services webpage.