Some people don’t need to be in a children’s story to think everything is bigger or smaller.
In the classic tale “Alice’s Adventures in Wonderland,” Alice encounters situations where the size of objects, creatures, and even herself is distorted.
However, while this phenomenon may have once only existed in fairy tales, the perception that you’re much larger or smaller than the world around you is a genuine brain-related condition that often affects children.
Medical experts believe that Charles Dodgson, the author, wrote about these symptoms based on his own experiences, as documented in his diary entries.
Named after the book, Alice in Wonderland syndrome (AIWS) is a rare neurological condition that disrupts the brain’s ability to process sensory input.
It can distort reality and how you perceive the size of things you see around you, the feel or look of your own body or both.
This condition often occurs in those under 18, with around 30% of teenagers experiencing brief symptoms, or people with certain brain-related conditions.
However, AIWS may be misdiagnosed or under-diagnosed due to how rare it is and because the symptoms and conditions that cause it are often temporary.
Possible causes include migraines, bacterial infections like Epstein-Barr or H1N1 influenza, seizures, strokes, hallucinogenic drugs, brain tumors or mental health conditions like schizophrenia and depressive disorders.
Symptoms are broken down into three types that can affect how your body feels or looks to you as AIWS changes the brain’s ability to monitor for potential problems and changes.
One symptom type is disturbances in self-perception or trouble correctly perceiving the size and feel of the body, occurring in around 3% of cases.
These self-perception symptoms often appear as changes in how you see your body or seeing parts of your body as too big or too small, along with derealization (a form of dissociation from the world), the feeling of being split in two and disruptions in time.
Another type that happens in the majority of AIWS diagnoses is disturbances in visual processing, or how your brain processes what you see around you.
This can show up as objects appearing larger or smaller than they are, changes in distance and things seeming closer or farther away, people appearing smaller than they are (Lilliputianism) and objects appearing distorted.
And the third type is combined symptoms that affect both self-perception and visual processing.
While there’s no way to conclusively diagnose this condition, doctors will ask about symptoms and perform neurological tests, such as CT or MRI scans, to rule out other brain-related conditions.
How long AIWS lasts and how it’s managed both depend on the underlying cause and the appropriate treatment for that particular cause.


