M is for Macropsia, Micropsia and Migraines – Associated Features of Alice in Wonderland Syndrome

Macropsia and Micopsia are perceptual symptoms that can be extremely distressing to individuals.  They are found in Todd Syndrome, named for the physician who first described the disorder.  Todd actually called the disorder, Alice in Wonderland Syndrome as the symptoms resemble those experienced by Alice in the book.  The disorder appears to be primarily associated with Migraines.

Alice in Wonderland Syndrome is a disorienting neurological condition primarily found in children.  The disorder is characterized by distorted time, space, and body image, with the passage of time seeming to slow down or speed up with the surrounding environment seeming to “zoom” in or out. Patients with AIWS have the sense that their entire body or specific parts of it have been altered in shape and size. These symptoms can be overwhelming for the child. 

The most common symptoms in Alice in Wonderland Syndrome are altered visual perceptions, specifically Macropsia or objects appearing larger than they really are and Micropsia or objects appearing much smaller than they really are.  These symptoms are particularly troubling as not all objects are affected so most things in the room may appear relatively normal but one of the chairs seems to be the size of a refrigerator while the couch appears as large as a minivan. These symptoms may also be mixed so while the couch seems to be the size of a minivan, the chair seems to be the size of a mouse.  Macropsia and Micropsia can affect inanimate and animate objects alike.   

Alice in Wonderland Syndrome is a rare neurological which may be associated with migraine, epilepsy and infectious mononucleosis. The disorder does not appear to be associated with damaged eyesight or brain tumors. The majority of patients with Alice in Wonderland Syndrome report a family history of migraines or suffer from migraine themselves.