Scientists Are Baffled By A Rare Disorder That Makes The World Look Cartoonish

At some point in childhood, your imagination ran wild and you might have envisioned yourself as smaller or larger, and a part of a world where all time seemed to stop. Yet it just so happens there is a real brain condition that can lead to cartoon-like perceptions of the world. In particular, this baffling syndrome can distort your perceptions of neurosensory processes such as your body schema, visual perceptions, and even time itself. Clinically known as Alice in Wonderland syndrome (AIWS), this perceptual disorder is considered rare with no single cause. AIWS may be temporary or chronic, with symptoms treated based on the suspected cause, although diagnosing this disorder (as with this other bizarre medical condition) can be challenging.

Named for Lewis Carroll's classic story of the same name, AIWS creates disruptions in the way you perceive yourself, objects, and other people. While AIWS is starting to get more recognition from a scientific standpoint, this condition was actually first identified by a British psychiatrist John Todd in 1955. As scientists have studied more of this unusual disorder, they have identified at least 16 body sensory perception symptoms as well as 42 visual symptoms (the most common), per the journal Neurology Clinical Practice. Just some of the examples of these symptoms include seeing objects or people in front of you change in size or motion, observing your own body shrinking or enlarging, and even perceiving types and characteristics of sounds at faster or slower rates. You may even feel disconnected from yourself and reality, or possibly feel like you've lost control of your own movements. These experiences can sometimes be frightening, even if they are benign.

Like other types of brain disorders, AIWS doesn't appear to have a single cause that triggers symptoms. Instead, there are a range of possible risk factors for AIWS development. Some of these include underlying mental health conditions, as well as brain-related conditions such as tumors, degenerative diseases, or stroke. Yet some of the most common causes are viral and bacterial infections, migraine, and seizures. Other possible, though less common causes of AIWS include certain over-the-counter, prescription, and recreational drugs. AIWS is sometimes erroneously misclassified as hallucinatory syndromes or schizophrenia spectrum disorders. Schizophrenia and schizoaffective disorders may increase the risk of AIWS, however, the perception disruptions experienced with AIWS are not the technically the same as hallucinations or psychosis.

When you do experience AIWS, the symptoms tend to present as temporary episodes. These can last several minutes to hours at a time. As a general rule, the more severe the underlying cause, the longer the possible symptom duration. Currently, there's no known way to prevent AIWS development.

AIWS is considered rare, but scientists are starting to discover that it may be more prevalent in certain age groups. Interestingly, AIWS is also considered most common in children, with an estimated two-thirds of reported cases occurring in those under the age of 18, says the Cleveland Clinic. At the same time, as many as 30% of all teenagers may experience symptoms on a temporary basis. Scientists still don't know why this age group is more susceptible to AIWS, and why there might be such a high incidence of temporary symptoms that can resolve on their own.

AIWS is unsurprisingly complex to diagnose, and a clinician will likely rule out other potential causes of related symptoms first. This first involves a standard physical exam as well as blood testing. Other possible tests might include an EEG to measure brain activity that could indicate epilepsy or non-epileptic seizures, or imaging of the brain via CT or MRI scans. A doctor might also recommend a visual evoked potential test, which helps to determine whether signals between your eyes and certain parts of the brain function together properly. Finally, if a health care professional suspects that an underlying infection is impacting your cerebral spinal fluid, they may recommend a spinal tap.

Depending on the underlying cause, this disorder is sometimes treated with antibiotics or antivirals, or medications to help treat epilepsy or migraine. If a certain medication is thought to contribute, a doctor might recommend an alternative for you to take. However, you should never discontinue any medications without first consulting with a health care professional. Despite such potentially helpful treatment modalities, AIWS may also mysteriously resolve on its own in about half of all cases.

Due to both the complexities of diagnosis and an overall lack of awareness, it's also thought that AIWS is underdiagnosed. As scientists continue to learn more about this disorder, more clear-cut diagnostic criteria might someday emerge. Until then, people who suspect they're experiencing symptoms of AIWS are encouraged to reach out to a health care professional, particularly if these are chronic and bothersome. While AIWS itself isn't harmful, it can accompany potentially life-threatening conditions that affect the brain, such as stroke. Any suspected signs of a stroke or a brain infection warrant emergency medical attention.