Size Matters: Living in a Lewis Carroll 'Wonderland'

Scientists examine a medical mystery that makes the world grow and shrink.


Sept. 18, 2007— -- In the blink of an eye, Katie O'Brien's view of the world can change. In seconds, the 19-year-old can feel as though she's living in a world that has shrunk to the proportions of a doll house. Other times everyday objects seem strangely large.

"Right when I wake up, that's when I'll start to see things differently," Katie said. "I was looking at the couch once and it looked like the couch just was growing. It was really weird. It was really horrible."

Katie said that she was more confused than frightened by the experience as a child. "I don't know if I was necessarily like, really scared. It was just something that didn't make sense. Something I didn't understand," she said.

Watch the story on "Primetime Medical Mysteries" Wednesday, Sept.19 at 10 p.m. EDT

Katie's mother, Denise O'Brien, can relate, because she'd had some of the same bizarre experiences when she was a child.

"I just remember feeling really tiny and everything got really big," she said. "And then, it reverses. … I mean, you know it hasn't happened, but, it just … it's a very odd sensation."

Denise O'Brien was in her 20s before she had any explanation. She and her daughter share a rare condition called Alice in Wonderland syndrome, named, of course, after Lewis Carroll's famous childhood fairy tale. Just think of the strange illusions experienced by Alice in the book. (CLICK HERE for more information about Alice in Wonderland syndrome).

In "Alice's Adventures in Wonderland," Alice describes growing so large that she can no longer see her feet: "Now I'm opening out like the largest telescope that ever was. Goodbye, feet." The Mayo Clinic's Dr. David Dotick said that experience is "rather typical … of the patients who describe this sort of distortion of body image."

Dotick is an expert in migraines and their accompanying auras -- those strange alterations in perception or physical sensations that can erupt just before a migraine strikes. Alice in Wonderland syndrome is connected to those devastating headaches that affect 28 million Americans.

"It's not just body image," said Dotick. "Sometimes patients describe mosaic vision, where they see a picture over your face that's fractured and looks like it's in little pieces. Or zoom vision where things seem very, very faraway or things seem … very, very close."

"Some feel as though only part of their body is morphing," he explained. "One patient said it was as if her ear was ballooning out 6 nches."

The syndrome can also cause bizarre alterations of time and space, a perception Katie O'Brien shares with her sister, Molly.

"I'll hear just normal sounds, people talking, driving, music, anything," said Molly. It doesn't get … high-pitched or anything. It's just, everything's just really, really quick."

Dotick says that people who suffer from this syndrome often think they're going crazy. "That's why they tend not to share it. That's why I think it's probably more common than we now recognize," he said.

For all three O'Briens, the Alice in Wonderland auras, which last up to 30 minutes, are a sign a migraine is on the way. Intriguingly, the syndrome can also occur with epilepsy.

"It's sort of a clue, when you have the aura, to go and hide for a while and get rid of it," said Denise.

Experts speculate that Lewis Carroll (whose real name was Charles Dodgson), a mathematics professor at Oxford University, may have suffered from migraine auras when he wrote "Alice." He created the story for 10-year-old Alice Liddell, thought to be the "real" Alice. Dotick acknowledges that "there's controversy" over the theory that the book was the result of migraine auras.

"The question is whether he suffered from migraine aura when he was doing his writing," said Dotick, "because he hadn't sort of recorded that in his diaries, but there's no question that he did suffer from aura."

It would be another 150 years before science would begin to unravel the mystery of why they occur. At Seattle Radiologists, researchers are attempting to capture, for the first time, an actual picture of Alice in Wonderland syndrome in the brain of 12-year-old Ana Ryseff.

Ana has the condition, too -- her auras last just a few minutes and only seem to happen when she's concentrating hard on a printed page.

"Sometimes when I'm really focusing on a piano piece, the notes will just zoom, zoom up, so they're just really big, like as if you were using a camera and you zoomed up on someone," she said.

Ana said that at other times the entire sheet of music will blow up in front of her. The same thing can happen when she's reading.

"I'm just looking at the book, holding it, my hands are the same size, but the book expands -- everything on the book, the pages, the words just, just everything," she said. "I was thinking, what the heck is happening? I, I just didn't know. I had no clue."

But she was about to find out just what was happening. In the scanning room, researchers used a flashing black-and-white checkerboard pattern to mimic the black-and-white of the printed page. Dr. Sheena Aurora, a neurologist, hoped to trigger Ana's aura inside a scanner and get a functional image of her brain.

It works, and Ana and her mother Kim got a look at something few people ever see -- the inside of Ana's brain as an Alice in Wonderland aura takes over her vision. Two areas of the brain lit up. A burst of electrical activity caused abnormal blood flow in the area that processes vision and the part of the brain that processes texture, size and shape.

"That's why you saw things become really small and really big," Aurora told Ana. "This activity definitely can explain the differences in size and shape and form."

Like Alice in Wonderland, Ana's adventures will likely have a happy ending. The syndrome tends to disappear as its sufferers get older. It's already slipping away from Katie. For Denise, it's just a memory … ;a looking glass version of reality, no longer, as Alice said, "curioser and curioser."

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