Author Lewis Carroll wrote of some truly bizarre events in his books "Alice in Wonderland," and "Through the Looking Glass and What Alice Found There." Alice goes through all kinds of metamorphic changes; she gets larger or smaller after ingesting certain liquids from labeled bottles, or experiences visual discrepancies such as double vision or hallucinations of smiling cats. Lewis had quite the imagination.
Or was it imagination?
Migraine researchers suggest Carroll was actually a Migraineur, and Alice's manifestations in the book were representative of his Migraine auras. His experiences are a recognized medical condition now called Alice in Wonderland Syndrome (AWS), which appears in various medical literatures. The condition was first described by CW Lippman in the Journal of Nervous and Mental Disease in 1952 and named by John Todd in the Canadian Medical Association Journal in 1954. Some noted symptoms of AWS include false orientation of objects in space, one object appearing as two or more, inverted vision, impaired sense of time, feeling detached and personality changes.¹
Alice's adventures seem to parallel Carroll's suffering as a Migraine patient. Alice
being blinded by moonlight could refer to a Migraineur's sensitivity to light;
other references are to medications and hallucinatory side effects. For example,
from "Alice's Adventures in Wonderland:" "In a minute or two the Caterpillar
took the hookah out of its mouth and yawned once or twice, and shook itself.
Then it got down off the mushroom, and crawled away in the grass, merely
remarking as it went, 'One side will make you grow taller, and the other side
will make you grow shorter.' 'One side of what? The other side of what?' thought
Alice to herself. 'Of the mushroom,' said the Caterpillar, just as if she had
asked it aloud; and in another moment it was out of sight."²
In a study published in 1998 in Contemporary Pediatrics, AWS might be seen as a
Migraine equivalent; a Migraine without head pain. This study describes the
typical patient as between five and 12 years old whose auras last between 10 and
60 minutes. The child can function without disability and usually has a family
history of Migraine.³ Other literature notes this phenomenon among children and
rarely among adults.
While Migraine is commonly associated with AWS, other diagnosis's can also fit the description, including epilepsy, Epstein Barr Virus, infectious mononucleosis or schizophrenia. Treatment for AWS is simple - the course is limited and temporary, the average length of time for symptoms is one month, no specific treatment is necessary during the acute episodes, offer reassurance and understanding, and treat any underlying conditions. Awareness of AWS and the differential diagnosis's can prevent incorrect treatment for the patient.
Carroll was the author of many books, but none seem to be as well known or have made as significant a contribution to the field of medicine as his "Alice in Wonderland" books.
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References:
¹ "Alice in Wonderland Syndrome" Power Point Presentation. Department of Paediatrics of the University of Ottawa at the Children's Hospital of Eastern Ontario (CHEO)
² "Alice's Adventures in Wonderland," chapter 5. Quote researched by Mark Burstein, Vice-President and Knight Letter Editor; The Lewis Carroll Society of North America.
³ Shevell, Michael, M.D., "A guide to Migraine equivalents," Contemporary Pediatrics, 71, June 1998.
4 "Migraine
aura symptoms gave rise to 'Adventures in Wonderland.'" MAGNUM, The National
Migraine Association.
