Health and Disease

Alice in Wonderland Syndrome: The Perceptual Disturbance

Alice in Wonderland Syndrome or Todd’s syndrome is a fascinating neurological condition. It affects the visual perception of individuals, as things around them can appear as bigger, closer and distorted.

Introduction and Symptoms

Alice in Wonderland Syndrome (AWS), also known as Todd’s syndrome, is a neurological condition where one’s visual perception is greatly distorted. To those with Alice in Wonderland Syndrome, things around them may appear to be bigger, closer, and more distorted. One’s own body can be perceived through a distorted viewpoint as well, as they may see themselves as smaller or bigger than they actually are in reality. Things or objects in the individual’s environment may appear farther as well, a symptom called Teleopsia. Another term is Pelopsia, where items in the surrounding environment appear to be closer to the individual. Micropsia is another symptom that describes things around the individual that seem smaller in perception, and Macropsia is when things in the surroundings of the individual appear to be bigger in perception and in perspective. Time perception can be greatly affected as well to those with the condition. Migraines are also a prominent symptom to those with Alice in Wonderland Syndrome. However, it does not only affect one’s vision. It can affect other senses as well, including the sense of touch and sound. For example, things may be louder in sound to an individual with the neurological condition of Alice in Wonderland Syndrome. There can also be a loss of maintaining coordination for those with Alice in Wonderland Syndrome. Some state that AWS can lead to seizures as well.


AWS, AIWS, or Todd’s syndrome is named the way it is due to Dr. John Todd, who identified it in the 1950s. He named it the Alice in Wonderland Syndrome as he felt that the symptoms were similar to those that were experienced by Alice in the novel: Alice’s Adventures in Wonderland by Lewis Carroll. He felt that the experiences Alice the protagonist experienced in terms of becoming smaller and bigger were reminiscent of those with the conditions. There was also the perception of time that was affected in the story, similar to how many felt with the condition. The name remained to describe this interesting neurological condition. 


Causes of Alice in Wonderland Syndrome or Todd’s Syndrome are emphasized through migraines, as well as temporal lobe epilepsy. Electrical activity in the brain can also progress to developing Alice in Wonderland Syndrome, as when unnatural electrical activity occurs it can cause blood to go into areas of the brain that are responsible for visual perception. This as a result affects the individual’s ability to perceive objects, the environment, and at times themselves. Brain tumors are also seen as a factor for the condition. Genetics can also play an important role in regards to developing the condition of Todd’s Syndrome. Head trauma can play a role in developing the condition, as well as stress. Epilepsy and stroke can also play a primary cause for an individual to develop Alice in Wonderland Syndrome. For children, the Alice in Wonderland Syndrome is most commonly caused by infection, while for adults, Alice in Wonderland Syndrome is mainly caused by migraine. Migraines are also seen to be a symptom as well, as those with the neurological condition can experience frequent migraines. Alice in Wonderland Syndrome is most commonly found to occur in children, however, can be still developed in adulthood as well. Moments, where perception feels distorted commonly, lasts for a couple of minutes, but it can extend to an hour and thirty minutes.

Treatment and Conclusion

There is no proven treatment or cure yet provided for Todd’s Syndrome or Alice in Wonderland’s Syndrome, and rather will be seen to slowly fade after certain periods of time. Treatment can be provided for relief, in order to aid with the condition and migraine that may be present. For example, migraine prophylaxis may be used to treat those with Alice in Wonderland Syndrome upon a medical professional’s instructions and directions. Being a rare condition, not many cases have been well known, and is still undergoing research today. Professionals continue to learn more and bring more insight in regards to this fascinating condition today. 

Bharathi Arivazhagan, Youth Medical Journal 2020


Weissenstein, Anne, et al. “Alice in Wonderland Syndrome: A Rare Neurological Manifestation with Microscopy in a 6-Year-Old Child.” Journal of Pediatric Neurosciences, Medknow Publications & Media Pvt Ltd, 2014,

Holland, Kimberly. “Alice in Wonderland Syndrome: Symptoms, Treatment, and More.” Healthline, Healthline Media, 17 Apr. 2019,

Blom, Jan Dirk. “Alice in Wonderland Syndrome.” Neurology Clinical Practice, Wolters Kluwer Health, Inc. on Behalf of the American Academy of Neurology, 1 June 2016,


By Bharathi Arivazhagan

Bharathi Arivazhagan is a student interested in the fields of public health and molecular biology.

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