Alice in Wonderland Syndrome: Somesthetic vs visual perceptual disturbance

In 1955, English psychiatrist John Todd (1914–1987) described Alice in Wonderland syndrome (AIWS) as self-experienced paroxysmal body image illusions involving distortions of the size, mass, or shape of the patient's own body or its position in space, often occurring with depersonalization and derealization.1 Todd named AIWS for the perceptual disorder of altered body image experienced by the protagonist in the novel Alice's Adventures in Wonderland (1865), written by Lewis Carroll2 (the pseudonym of Reverend Charles Lutwidge Dodgson [1832–1898]), possibly based in part on Dodgson's own migrainous experiences.3 In the story, Alice followed a talking white rabbit down a rabbit hole and then experienced several dramatic changes in her own body size and shape (e.g., shrinking to 10 inches high, growing unnaturally large, and growing unnaturally tall but not any wider).2 Although Todd's report was the most influential, Lippman4 provided an earlier description in 1952. In Lippman's article, one of the patients reported feeling short and wide as she walked, and referenced Alice's Adventures in Wonderland in regard to her body image illusions, referring to them as a “Tweedledum” or “Tweedledee” feeling.