Alice in Wonderland syndrome is a brain-related condition that disrupts how you perceive your own body, the world around you or both. Named for a famous children’s storybook, this rare condition makes things look or feel larger or smaller than they actually are. It can happen for several reasons, many temporary or treatable. 

Self-perception symptoms 

Your brain monitors and manages your body’s functions. This is extremely important, as it keeps you safe and healthy. However, it’s also possible for something to go wrong with that ability, which is what happens with self-perceptive symptoms of AIWS. They include: 

• Changes in your perception of your body. This can cause part of your body to feel too big (partial macrosomatognosia) or too small (partial microsomatognosia). This effect can also cause your whole body to feel unusually tall (total macrosomatognosia) or unusually short (total microsomatognosia). 
• Derealization. This is a form of dissociation when you feel disconnected from the world around you. 
• Depersonalization. This type of dissociation makes you feel disconnected from your own body, thoughts or feelings. Some people describe this as feeling like watching your own life in third-person, as if you were watching from over your own shoulder or outside of yourself. 
• Feeling of being split in two. Known as somatopsychic duality, people often describe this as feeling as if they’re split in two vertically. That makes them feel as if their body’s left and right halves exist separately, but they can still feel both. 
• Disruption in sense of time. This changes your ability to judge the passage of time. People who experience this may feel that time is standing still or as if time is greatly slowed or sped up.

Visual perception symptoms 

The most common symptoms of AIWS affect visual perception. That means the symptoms affect the way you see things around you. They include: 

• Changes in size. Objects may appear larger (macropsia) or smaller (micropsia) than they actually are. 
• Changes in distance. Objects may appear closer (pelopsia) or farther away (teleopsia) than they actually are. 
• Changes in both size and distance. Objects may appear smaller and seem to be moving farther away (porropsia). 
• People appearing smaller than they actually are. This is known as Lilliputianism (pronounced “lil-ip-yew-shun-ism”). This gets its name from the fictional, tiny residents of the island of Lilliput from the 1726 fantasy novel “Gulliver’s Travels” by Jonathan Swift. 
• Changes in object appearance. Objects can appear distorted. Straight lines can look wavy or squiggly. Lines that are level vertically or horizontally can look skewed or slanted.

AIWS Testing: How to Know 

It can be challenging for healthcare providers to diagnose AIWS. Episodes are brief, the condition is understudied, and no set criteria define it. To do so, healthcare providers—often neurologists (brain specialists)—use physical exams, health history, and neurological tests to assess how well you see and move. 

Since a range of physical, neurological, and psychological conditions can cause symptoms like AIWS, providers may also need to perform additional tests and exams, such as:1 

• Blood tests: Testing blood samples helps providers detect underlying infections or diseases. 
• Lumbar puncture: Providers test samples of cerebrospinal fluid surrounding the brain and spinal cord for signs of brain infection. 
• Electroencephalogram (EEG): EEG maps the brain's electrical activity to help diagnose seizures, epilepsy, or other neurological disorders. 
• Magnetic resonance imaging (MRI): MRI is a form of X-ray that produces three-dimensional (3D) brain images to screen for brain tumors or lesions. 
• Visual evoked potential: This test assesses how well nerve signals travel from your eye to the brain.      

What treatment options are available? 

There’s no treatment for AWS. If you or your child experiences symptoms, the best way to handle them is to rest and wait for them to pass. It’s also important to reassure yourself or your loved one that the symptoms aren’t harmful. 

Treating what you and your doctor suspect is the underlying cause for AWS episodes may help prevent an episode. For example, if you experience migraines, treating them may prevent future episodes.

Tourette Syndrome (TS) is a neurological disorder characterized by involuntary or semi-voluntary movements (motor tics) and sounds (vocal tics). Common motor tics include eye blinking, facial grimacing, and arm or leg jerking. Vocal tics can include involuntary shouting, grunting, or using obscene language.

The criteria used to diagnose Tourette's syndrome include:

• Both motor tics and vocal tics are present, although not necessarily at the same time
• Tics occur several times a day, nearly every day or intermittently, for more than a year
• Tics begin before age 18
• Tics aren't caused by medications, other substances or another medical condition

Tics must change over time in location, frequency, type, complexity or severity

Symptoms

Tics — sudden, brief, intermittent movements or sounds — are the hallmark sign of Tourette syndrome. They can range from mild to severe. Severe symptoms might significantly interfere with communication, daily functioning and quality of life.

Tics are classified as:

• Simple tics. These sudden, brief and repetitive tics involve a limited number of muscle groups.
• Complex tics. These distinct, coordinated patterns of movements involve several muscle groups.
• Tics can also involve movement (motor tics) or sounds (vocal tics). Motor tics usually begin before vocal tics do. But the spectrum of tics that people experience is diverse.

Common motor tics seen in Tourette syndrome

• Simple tics, Complex tics, Eye blinking, Touching or smelling objects, Head jerking, Repeating observed movements, Shoulder shrugging, Stepping in a certain pattern, Eye darting, Obscene gesturing, Nose twitching, Bending or twisting, Mouth movements, and Hopping.

Common vocal tics seen in Tourette syndrome

• Simple tics, Complex tics, Grunting, Repeating one's own words or phrases, Coughing, Repeating others' words or phrases, Throat clearing, and Using vulgar, obscene or swear words

Diagnosis

There's no specific test that can diagnose Tourette syndrome. The diagnosis is based on the history of your signs and symptoms.

The criteria used to diagnose Tourette syndrome include:

• Both motor tics and vocal tics are present, although not necessarily at the same time
• Tics occur several times a day, nearly every day or intermittently, for more than a year
• Tics begin before age 18
• Tics aren't caused by medications, other substances or another medical condition
• Tics must change over time in location, frequency, type, complexity or severity