Signs of Alice in Wonderland Syndrome

Alice in Wonderland syndrome (AIWS) is one of those conditions that sounds fictional until you realize how many people quietly experience it—especially people with migraines. For some, it shows up as part of a migraine attack. For others, it appears on its own or alongside different health conditions. Either way, it can be confusing, unsettling, and hard to describe.

You don’t need a migraine diagnosis to recognize yourself here, and having these symptoms doesn’t mean something is “wrong” with you in a moral or psychological sense. AIWS is a neurological experience, not a personal failure.

What Is Alice in Wonderland Syndrome?

Alice in Wonderland syndrome is a neurological perceptual disorder characterized by temporary distortions in how the brain processes sensory information. These distortions can affect:

The perceived size of objects or body parts
The distance between you and the world around you
Your sense of time
How your own body feels in space

The syndrome was first formally described in 1955 by psychiatrist John Todd, who noticed these symptoms in patients with migraines, epilepsy, and infections, and named the condition after Lewis Carroll’s famous novel.

Crucially, people experiencing AIWS usually know that something strange is happening. This awareness is one of the features that distinguishes it from psychosis or hallucinations.

Why Alice in Wonderland Syndrome Is So Often Linked to Migraines

Among all known associations, migraines are the most common condition linked to Alice in Wonderland syndrome, particularly migraines with aura. Multiple reviews and case studies show that AIWS symptoms frequently appear:

Before a migraine attack
During a migraine
Occasionally between attacks in people with chronic migraine

Research suggests that AIWS may be a variant or extension of migraine aura, involving changes in how the brain temporarily processes sensory input.

This helps explain why AIWS often appears alongside other migraine-related sensory symptoms like light sensitivity (photophobia), sound sensitivity (phonophobia), and smell sensitivity (osmophobia).

Core Signs of Alice in Wonderland Syndrome

While everyone’s experience is slightly different, the signs of AIWS tend to fall into a few recognizable patterns.

1. Size Distortion (Micropsia and Macropsia)

This is one of the most well-known signs and one of the most common in migraine-related AIWS.

Micropsia: Objects or body parts appear smaller than they really are
Macropsia: Objects or body parts appear larger than they really are

For someone with migraines, this might happen:

During the aura phase
At the peak of pain
During severe postdrome (“migraine hangover”)

Clinical studies have documented these distortions in both adult and pediatric migraine patients.

2. Distorted Perception of Your Own Body

Another hallmark sign—especially unsettling if you don’t know what it is—involves changes in how your body feels or looks to you.

People may feel:

Their hands, feet, or head are unusually large or small
Parts of their body feel far away or unreal
A sense of being “out of proportion”

This is sometimes called somesthetic distortion and is thought to involve temporary dysfunction in the parietal lobes, which integrate sensory and spatial information.

In migraine patients, these sensations often coexist with dizziness, nausea, or visual changes.

3. Distance and Spatial Distortions

AIWS can also affect how far away things seem, even though vision itself is intact.

Teleopsia: Objects feel farther away than they are
Pelopsia: Objects feel closer than they are

For migraine sufferers, this may make rooms feel overwhelming, or movement feel disorienting, especially during aura or severe headache phases.

4. Time Distortion (Common but Under-Discussed)

Many people with migraines already notice time distortion during attacks. In AIWS, this symptom can become more pronounced.

You might feel like:

Time is dragging painfully slowly
Events are speeding past you
Moments are looping or fragmented

Neurological research suggests that altered temporal perception may be related to disrupted cortical processing during migraine and AIWS episodes.

5. Visual Distortions Without Vision Loss

Unlike eye conditions, Alice in Wonderland syndrome doesn’t usually involve blurry vision or blindness. Instead, it causes interpretive distortions, such as:

Straight lines appearing curved
Objects seeming flat or oddly three-dimensional
Familiar spaces feeling “wrong” or unreal

These effects are believed to involve the temporo-parietal-occipital junction, a region heavily implicated in migraine aura.

Emotional and Physical Symptoms That Often Come With AIWS

Especially in migraine-related cases, AIWS rarely appears alone. It may be accompanied by:

Headache pain or pressure
Nausea or vomiting
Light, sound, or smell sensitivity
Anxiety during the episode
Fatigue afterward

These secondary symptoms don’t mean the experience is “just anxiety.” They reflect how disruptive sudden perceptual changes can be for the nervous system.

Alice in Wonderland Syndrome Outside of Migraines

While migraines are the most common association, AIWS is not exclusive to them. It has also been reported in connection with:

Epilepsy, particularly temporal lobe epilepsy
Viral infections, including Epstein–Barr virus
Head injury or concussion
Neurological inflammation
Certain medications

In children, infections are a more frequent cause; in adults, migraines dominate the clinical picture.

How Long Do Episodes Last?

AIWS episodes are usually temporary, lasting:

Minutes
Up to a few hours

In migraine-related cases, the duration often mirrors the migraine phase in which it occurs. Chronic or constant symptoms are uncommon and should prompt medical evaluation.

Is Alice in Wonderland Syndrome Dangerous?

AIWS itself is not considered dangerous or degenerative. It does not damage the brain and does not mean you are losing touch with reality.

That said, you should seek medical evaluation if:

Symptoms are new or worsening
Episodes occur with seizures, weakness, or confusion
There is a recent infection or head injury

For people with migraines, AIWS is often managed indirectly by treating the migraine condition itself.

Coping With AIWS During a Migraine

While there’s no specific treatment for AIWS alone, migraine-focused strategies often help:

Reducing sensory input (dark, quiet room)
Lying down and grounding physically
Staying hydrated
Using prescribed migraine treatments as directed
Tracking AIWS symptoms as part of your migraine diary

Understanding what’s happening can reduce panic, which in turn can shorten or soften episodes.

Living With AIWS When You Have Migraines

One of the hardest parts of AIWS is how difficult it is to explain. Many people worry they’ll be misunderstood or dismissed.

If this resonates:

You are not alone
This is a recognized neurological phenomenon
Many migraine specialists are familiar with it

Knowing the name doesn’t make the experience disappear—but it often makes it far less frightening.

Reminder

Alice in Wonderland syndrome sits at the crossroads of migraine, perception, and the nervous system’s complexity. For many people with migraines, it’s another reminder that migraines are not “just headaches,” but whole-brain events that can temporarily alter how reality feels.

Whether you experience AIWS as part of migraines or on its own, understanding the signs can replace fear with clarity—and help you advocate for yourself in medical settings.

Migraine

Signs of Alice in Wonderland Syndrome: When Perception Feels Distorted