Migraine with aura can have some very strange visual symptoms that may be quite alarming. Flashing lights, zigzag lines, even partial vision loss can occur during one of these Migraine attacks. One rare type of Migraine aura, Alice in Wonderland Syndrome (AIWS), has some symptoms that are quite bizarre, and we can thank Charles Lutwidge Dodgson, aka Lewis Carroll, for its name.
Charles Lutwidge Dodgson was born on January 27, 1832, in Daresbury, Cheshire, England, to Reverend Charles Dodgson and Frances Jane Lutwidge. His father was perpetual curate at an isolated parsonage in Daresbury, which made it difficult for the children to make friends and meet people. Charles soon discovered he was a good source of entertainment for his siblings when he learned to create imaginative games. These kept his younger brothers and sisters occupied much of the time when they were not being home-schooled. When Charles was 11, his family moved to Croft-on-Tess, Yorkshire, where his father became rector and remained in that position for the rest of his life. Part of Rev. Dodgson's duties including having the family write in the "Rectory Magazines," but it seems that Charles wrote most of them. Some that survived include; "Useful and Instructive Poetry" (1845,) "The Rectory Magazine" (c.1850,) "The Rectory Umbrella" (1850-1853) and "Mischmasch" (1853-62; published with "The Rectory Umbrella".)
Charles attended school in Richmond, Yorkshire, for a year, then transferred to The Rugby School from 1844 to 1850. He was very unhappy during these years as he was plagued by shyness, bullying, and illness that left him deaf in one ear. In 1850, he was accepted at Christ Church, Oxford. Unfortunately, a few days after he arrived at Oxford, his mother suddenly passed away. While at Oxford, he performed above expectations in math and classical studies. As part of his acceptance at Christ Church, he received a fellowship on the contingency that he would take his holy orders after he received his master's degree. He indeed graduated in 1854 with a BA degree holding the number one spot in his class in mathematics and number three in classics studies. After graduation, he became a math tutor, was appointed to a library position, and finally appointed as a Mathematical Lecturer at Christ Church. He then went on to study for his Masters degree and became an ordained deacon in 1861. It was during this time that he took his pen name, Lewis Carroll, by translating Charles Lutwidge into Latin, then translating back to English and reversing it.
While at Christ Church he became friendly with Dean Henry George Liddell's children, Alice, Lorina, and Edith, among others. It wasn't surprising he got along so well with children seeing as he came from such a large family. What's interesting, though, is that his stuttering never seemed to be a problem when he was surrounded by his "child" friends. The Liddell children would often visit Dodgson in his dormitory room, always properly chaperoned by Mrs. Prickett, better known as "Pricks" - "one of the thorny kind." Mrs. Prickett may have been the model for the Red Queen in "Through the Looking-Glass." Alice wrote on one visit they:
"used to sit on the big sofa on each side of him, while he told us stories, illustrating them by pencil or ink drawings as he went along... He seemed to have an endless store of these fantastical tales, which he made up as he told them, drawing busily on a large sheet of paper all the time. They were not always entirely new. Sometimes they were new versions of old stories; sometimes they started on the old basis, but grew into new tales owing to the frequent interruptions which opened up fresh and undreamed-of possibilities."1
On another visit with the Liddell's in 1862, Lewis and Reverend Canon Duckworth took the children on a boat ride rowing across a local part of the Thames River. While rowing home, Alice became bored and wanted Dodgson to tell her a story "with lots of nonsense in it." Dodgson's tale seems to be based on an outing the group had a few weeks earlier and were caught off guard in the rain. Duckworth commented on the trip:
"I rowed stroke and he rowed bow (the three little girls sat in the stern)...and the story was actually composed over my shoulder for the benefit of Alice Liddell, who was acting as 'cox' of our gig...I remember turning around and saying, 'Dodgson, is this an extempore romance of yours?' And he replied, 'Yes, I'm inventing it as we go along.'"2
So how do we get from fairy tale to Alice in Wonderland Syndrome? It is clear that Dodgson had a wonderful imagination and many of his inspirations were from children. There are some theories that Dodgson himself suffered from Migraine and may have experienced some of the symptoms he describes in his book, "Alice in Wonderland." Some AIWS symptoms include feeling as if your body is too big or too small, time may feel like it slows down or speeds up, and as if you're missing body parts. We can see where some of his thinking comes from in a few of his drawings done in the late 1850's. AIWS gets its name, according to some researchers, from the section in the book "Alice in Wonderland" when Alice jumps down the rabbit hole, drinks the liquid that causes her to shrink, then later eats the cake that makes her grow.
As scary as these symptoms can be, once diagnosed, AIWS is typically treated the same way as Migraine with aura with a good Migraine management plan that includes trigger identification and management and prevention.
1 Biography.Com TrueStory. Lewis Carroll.
2 Lenny's Alice in Wonderland site. About "Alice's Adventures in Wonderland."
3 Evans, Randolph W., Rolak, Loren A. The Alice in Wonderland Syndrome. Headache 2004;44:624-625.
4 Podoll, Klaus. Migraine Aura Foundation. Reuters Health. "Migraine Hallucinations said may have inspired 'Alice' tales." April 24, 1999.
5 Wakeling, Edward. Lewis Carroll Site. Fact Sheet 1.