Perceptual disorders that seem to be based on Lewis Caroll's world bestseller are often symptoms of an underlying disease such as migraine or epilepsy.

The mathematician Lewis Carroll published the world's bestseller "Alice's Adventures in Wonderland" in 1865. It is about the little girl Alice who, out of curiosity, follows a white rabbit that is always looking at its watch and is late. Through the rabbit hole she enters a room full of doors and finally into the colourful and bizarre wonderland, where she meets a caterpillar, the mad hatter and the queen of hearts.

But this fantastic story also gives the name to a perceptual disorder in which perceptual distortions can occur that are reminiscent of the events in the book: the "Alice in Wonderland Syndrome" (AIWS). However, this syndrome has no psychiatric character. Rather, it occurs as a possible side effect of migraine, epilepsy or other diseases.

Alice in Wonderland Syndrome refers to a perceptual disorder in which those affected see their environment and themselves distorted. Above all, people, animals and objects appear smaller or larger than they actually are. The name is deceptive in that it is not an independent disease. Rather, such an aura occurs in the preliminary phase of an epileptic seizure or migraine attack. Some children suffer from migraines as dizzy spells, they become nauseous and vomit. Before that they are plagued by vivid hallucinations. Usually the syndrome does not occur alone, but together with other diseases, such as migraine, epilepsy, brain damage, Creutzfeld-Jakob disease, high fever, drug use, sleep paralysis or viral infections.

Alice in Wonderland syndrome includes auditory hallucinations, increased tactile sensation and a loss of feeling for time and space. Because their perception changes, those affected can lose their orientation and fall. Outsiders may also interpret the behaviour as a mental illness, which it is not. Other possible symptoms are anxiety, panic attacks, the feeling of going crazy, an altered perception of one's own body, distorted vision, sudden tiredness, nausea to vomiting, dizziness, headaches or paleness.

The Alice in Wonderland syndrome cannot be treated independently so far. It is characterized more by distortions of perception than by hallucinations or illusions and must therefore be distinguished from psychotic disorders. Those affected should be informed that the symptoms themselves are not harmful. The focus is on the therapy of the underlying disease, such as migraine. The syndrome often improves as soon as the underlying disease is successfully treated. If the syndrome occurs in childhood, it often disappears during puberty or in young adulthood.

* This text may contain translation errors as the translation was performed by an online translation tool.