Macropsia Syndrome (Alice in Wonderland Syndrome)

Introduction

Macropsia syndrome, also known as Todd’s syndrome or Alice in Wonderland syndrome (AIWS), was first identified in 1955 by British psychiatrist John Todd. It is a condition characterized by visual perception, body schema, and time perception distortions. The name is a reference to Lewis Carroll’s book Alice’s Adventures in Wonderland, in which Alice experiences her body becoming both larger and smaller, among other things. 

Studies

According to studies conducted over the last 60 years, macropsia syndrome has signs that are both visible, somaesthetic, and nonvisual. Although, these symptoms are general in that they are sensory perception distortions rather than hallucination or illusion by themselves. Therefore, distinguishing AIWS from the schizophrenia spectrum or other psychotic disorders because hallucinations work as inappropriate stimuli from the outside world. It is a distortion of perceptions in macropsia syndrome precepts from the outside world. It causes illusory changes in the size, distance, or position of stationary objects in the visual field.

The number of case descriptions about the issue is not adequate, because the syndrome is mostly considered well-mannered. Symptoms may come out spontaneously, occasionally, and sporadically, or not received seriously by patients. The symptoms might both stop eventually, or continue. The symptoms are “clinical” if the patient is in the condition of neurologic, psychiatric, or other medical diagnosis. But, if patients experience symptoms with no medical attention, it is referred to as “nonclinical”. The causes of the syndrome are not accurate, but researchers stated that the syndrome can be associated with migraines, epilepsy, and infections. 

Interview with macropsia syndrome patient 

According to my interview with a 25 years old non-clinical macropsia syndrome patient, I realized that she didn’t have any information about her experience related to macropsia. She cannot even understand why she experienced distortions of perception. While she experiences the syndrome, she understands that she is not alone and searches for information about the syndrome. She expresses that it could have caused her seizure. And, it may may have caused her high temperature of about 43 degrees while she was 12 years old.

Suffering seizures may not be evidence, but could be a possible reason according to studies related to Macropsia. Many people were experiencing the syndrome and they experienced it similar to her. She also stated that illusions or hallucinations come before she falls asleep or feels sleepy. In one of her experiences of Macropsia, she had to check her credit card number during the day for some reason. While she was lying in bed in the evening, she suddenly experienced “7”, the last digit of the card number. It suddenly grew and grew and she wandered around the number 7.

One other experience happened in a public bus in the middle of Boğaziçi Bridge. While watching the sea from the bus, the waves suddenly grew so enormous for her that she felt the waves coming on and swept her away. She also indicated that the perception of time changed in this process. She said that “When I read a book while everything goes in its normal flow, I suddenly feel like time is flowing faster, but when I look around, everything continues in its flow as it should be.” She found out illusions are stimulated with stress and fatigue. Another interesting point is, while she is experiencing this distortion of perception, she perceives a solid tissue of growing objects in her tongue but the tissue has no taste. 

Conclusion

As a person who does not experience a perceptual disorder, it is not that easy to perceive the illusions of expansion of a macropsia patient because as mentioned before, the syndrome is completely individual and perceptual.

References

Blom, J. D. (2016). Alice in Wonderland syndrome: a systematic review. Neurology: Clinical Practice, 6(3), 259-270.

Liu, A. M., Liu, J. G., Liu, G. W., & Liu, G. T. (2014). “Alice in Wonderland” syndrome: presenting and follow-up characteristics. Pediatric neurology, 51(3), 317-320.