Have you ever wondered why Lewis Carroll’s “Alice in Wonderland” seems like such a trippy and surreal journey? Maybe even a little disturbing. Well, there’s a fascinating theory that connects this whimsical tale to a peculiar phenomenon known as “Alice in Wonderland Syndrome” or AIWS. This syndrome is closely associated with migraines and can offer a curious glimpse into the world of distorted perceptions. It is believed that Lewis Carroll himself had migraines. So, this may be a tale expressing what he was experiencing personally.

What is Alice In Wonderland Syndrome or AIWS?

Alice in Wonderland Syndrome (AIWS) is a rare and intriguing neurological condition, often linked to migraines. But, it can also be triggered by head trauma, and viral encephalitis caused by Epstein–Barr virus infection. Most commonly, AIWS is observed in children, though it can affect people of all ages.

How Does AIWS Present?

This syndrome is like a “hall of mirrors” for your senses, affecting vision, sensation, touch, and hearing. It can cause a distorted perception of:

  • object sizes, including your own body parts,
  • depth or distances,
  • colours (everything becomes one colour or loses colour).
  • time,
  • the speed of which an object is moving,
  • and sound, amongst other things.

It can also result in:

  • a perception of you being outside of your actual body,
  • visual splitting where objects appear split down the middle,
  • and hallucinations.

The hallmark of AIWS is a distortion in sensory perception, which includes visual, somatosensory, and non-visual symptoms. These episodes can vary in length, lasting from a few minutes to an hour, and the experience can be quite different for each person. One intriguing aspect of AIWS is its potential to induce feelings of paranoia.

How is AIWS Diagnosed?

Diagnosing AIWS can be a challenge because it’s not well-documented, and there is no established diagnostic criteria. It’s often presumed when other possible causes are ruled out. The exact causes of AIWS remain elusive, but it’s often associated with migraines, excessive screen use in dark spaces, and the use of psychoactive drugs. Epstein–Barr virus is a known cause in children, while migraines are more commonly associated with adults.


According to Liu (2014), the prognosis for AIWS varies from person to person, depending on whether an underlying cause can be identified. Symptoms can disappear on their own or with the treatment of underlying conditions. In some cases, they can persist and even develop into new visual disorders or migraines.


Currently, there is no standardized treatment for AIWS (Toole 2017). When needed, the focus is on treating the suspected underlying disease, such as migraines, epilepsy, or viral infections. Antipsychotics are rarely used because they offer minimal effectiveness in managing AIWS symptoms. (Blom 2016)


The prevalence of AIWS remains uncertain due to the lack of established diagnostic criteria and awareness about the syndrome. However, studies suggest that it might not be as rare as we think and especially among adolescents. (Kazuhiko 1989)


In conclusion, the world of “Alice in Wonderland” might be more real than you think, and AIWS offers us a fascinating peek into the rabbit hole of altered perceptions and experiences. While it remains a mysterious and poorly understood condition, the connection between this syndrome and Lewis Carroll’s classic tale adds an extra layer of intrigue to both the story and the condition itself.

If you think you or someone you know may be experiencing these odd sensation from migraines, feel free to give North 49 a call. Alternatively, you can book an Initial Assessment online. One of our team physiotherapists can work with you and your healthcare team to develop an individualized treatment program to manage your symptoms and migraine better. It is also important to rule out other causes of your symptoms. Your health care team may consist of your family physician, nurse practitioner, and possibly neurologist.