Abstract
How should Alice in Wonderland syndrome be diagnosed? How should it be treated? For numerous other medical conditions, diagnostic criteria are available from scientific organisations such as the World Health Organization, the American Psychiatric Association, the International League Against Epilepsy and so on. In addition, these organisations may issue evidence-based guidelines which stipulate how disorders should preferably be treated. However, for Alice in Wonderland syndrome, no such diagnostic criteria and therapeutic algorithms are available. As you probably have guessed, that is because the syndrome has until now hardly been investigated. As a consequence, Alice in Wonderland syndrome is perhaps the poster child for orphan diseases: a condition ‘forgotten’ by the powers that be and, therefore, playing no role whatsoever in the canon of medicine.
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Notes
- 1.
For implementation in the ICD or DSM , these classification systems might benefit from a new chapter called Perceptual Syndromes, in which not only Alice in Wonderland syndrome finds its rightful place but preferably also conditions such as musical hallucination s, sexual hallucinations , tinnitus , exploding head syndrome , clinical zoanthropy and the incubus phenomenon , all of which are currently underserved in these systems.
- 2.
Thus, I myself had a patient who suffered from visual and auditory distortion s, the latter consisting of an inability to filter environmental sounds and to distinguish between ‘foreground’ and ‘background’ sounds. As a consequence, my patient perceived all sounds as equally loud and had great difficulty concentrating on the ones that were relevant. Although not mentioned by Todd in his original paper, this may imply that distortions experienced in the auditory modality should also be allowed to count as symptoms of Alice in Wonderland syndrome.
References
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Blom, J.D. (2020). Diagnosis and Treatment. In: Alice in Wonderland Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-030-18609-8_6
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