Just Ask Alice

Through the Looking Glass

Almost every English speaking adult and child has either read or seen Alice in Wonderland - Through the Looking Glass.

Perhaps one of the most memorable parts of the story occurs when Alice's adventures with growing taller and then growing smaller get her tangled with the Mad Hatter, the Cheshire Cat and the White Rabbit.

In the book we saw illustrations of Alice with exaggerated and strange dimensions such as an extra-long neck, like a giraffe, and a wide lower body on top of long legs. When a person has Alice in Wonderland Syndrome, they feel just like Alice looked, as if their bodies and the objects around them are going through the same changes Alice's body went through in the story.

Alice In Wonderland Syndrome

Alice in Wonderland Syndrome (AIWS), also known as metamorphosia, is characterized by the distortion of visual images. Objects become smaller or larger and the sufferer may have the sensation of being very tall, feeling as though his neck is stretched very long, or perceiving that one part of the body is larger or smaller than the rest.

The frustration lies in the fact that the person knows the perception is not correct and looking in the mirror belies what they feel inside. Other perceptions include thinking the fingers are long and slender when in fact they are short and chubby.

AIWS and Epstein-Barr Virus

AIWS has the potential to cause migraine headaches, and conversely, the syndrome can appear as a result of migraines. Often it is difficult to tell which came first.

Many doctors commonly prescribe migraine medications for patients with AIWS. However, migraine headaches are not the only connection for Alice in Wonderland Syndrome. The other most common cause of these strange body perceptions is an infection with the Epstein-Barr Virus (EBV), the virus that causes infectious mononucleosis (also called glandular fever).

It is known that mono can cause a wide variety of neurologic complications, but it wasn't until 1977 that the research concluded EBV and mono could also cause AIWS. Additionally, AIWS may be the only symptom presented for infectious mononucleosis.

AIWS is often more prevalent in children than in adults and lasting for a few weeks. Some have to deal with it for a long period of time after the initial onset.

Will It Ever Go Away?

There is not a known cure for AIWS that is caused by mononucleosis. That is because the exact mechanics of how this syndrome works when caused by EBV are not fully known. The symptoms usually resolve within a few months but those months can be the most difficult on record.

They can also be dangerous for some people, making just getting through the day a major challenge. Some doctors use migraine medications to deal with the symptoms of AIWS and add the already known applications of rest and sleep, dietary exclusions of sharp cheeses, red wine, chocolate and other stimulants often associated with migraine headaches.

When the treatment is geared to someone who has mono and is experiencing AIWS, rest, lots of fluids and painkillers to relieve fever and pain are usually prescribed.

Extensive swelling may be addressed with steroids, but steroids tend to suppress the immune system, which means that mono may return when the steroids are stopped.