Curiouser & curiouser

Vaughan has found a fascinating article about the many references to neurological syndromes in Lewis Carroll's Alice's Adventures in Wonderland.

On the right is one of Sir John Tenniel's original illustrations for the book. It accompanies the following passage:

"Curiouser and curiouser!" cried Alice (she was so much surprised, that for the moment she quite forgot how to speak good English); "now I'm opening out like the largest telescope that ever was! Good-bye, feet!" (for when she looked down at her feet, they seemed to be almost out of sight, they were getting so far off). "Oh, my poor little feet, I wonder who will put on your shoes and stockings for you now, dears? I'm sure I shan't be able! I shall be a great deal too far off to trouble myself about you: you must manage the best way you can; - but I must be kind to them," thought Alice, "or perhaps they won't walk the way I want to go! Let me see: I'll give them a new pair of boots every Christmas."

Here, Carroll is describing a condition called macrosomatognosia, in which the perception of the body image is altered. This condition has been associated with lesions in a specific region of the right parietal lobe, which is involved in integrating perceptual and sensori-motor information. As a result, a part or parts of the body are perceived as being disproportionately large. In a related condition called microsomatagnosia, the opposite happens - parts of the body are preceived as being smaller than they actually are.

Micro- and macrosomatognosia (which are sometimes referred to as "Alice in Wonderland Syndrome") are often associated with migraine. The alterations of body image perception are sometimes experienced in the visual hallucinations that are symptomatic of the aura (the changes in brain function that precede, and warn of, the onset of a migraine in about 15% of migraine sufferers). Carroll is known to have suffered from migraines, so the description of macrosomatognosia abovce may have arisen from his own experiences.