Alice in Wonderland Syndrome: An Update of Present Data With A Special View to Body Position, Traumatic and Genetic Aspects

Alice in Wonderland Syndrome (AIWS) was named after the description of Lewis Carroll in his novel. In 1955, John Todd, a psychiatrist described this entity for the first time and results in a distortion of perception. Todd described it as „Alice's Adventures in Wonderland“ by Lewis Carroll. The author Carroll suffered from severe migraine attacks. Alice in Wonderland Syndrome is a disorienting condition of seizures affecting visual perception. AIWS is a neurological form of seizures influencing the brain, thereby causing a disturbed perception. Patients describe visual, auditory, and tactile hallucinations and disturbed perceptions. The causes of AIWS are still not known exactly. Cases of migraine, brain tumors, depression episodes, epilepsy, delirium, psychoactive drugs, ischemic stroke, depressive disorders, and EBV, mycoplasma, and malaria infections are correlating with AIWS like seizures. Often no EEG correlate is found. Neuroimaging studies reveal disturbances of brain regions including the temporoparietal junction, the temporal and occipital lobe as typical localization of the visual pathway. A decrease of perfusion of the visual pathways could induce these disturbances, especially in the temporal lobe in patients with AIWS. Other theories suggest distorted body illusions stem from the parietal lobe. The concrete origin of this mysterious syndrome is to date not clearly defined.