Time Distortions: A Systematic Review of Cases Characteristic of Alice in Wonderland Syndrome

Abstract

Of the perceptual distortions characteristic of Alice in Wonderland syndrome, substantial alterations in the immediate experience of time are probably the least known and the most fascinating. We reviewed original case reports to examine the phenomenology and associated pathology of these time distortions in this syndrome. A systematic search in PubMed, Ovid Medline, and the historical literature yielded 59 publications that described 168 people experiencing time distortions, including 84 detailed individual case reports. We distinguished five different types of time distortion. The most common category comprises slow-motion and quick-motion phenomena. In 39% of all cases, time distortions were unimodal in nature, while in 61% there was additional involvement of the visual (49%), kinaesthetic (18%), and auditory modalities (14%). In all, 40% of all time distortions described were bimodal in nature and 19% trimodal, with 1% involving four modalities. Underlying neurological mechanisms are varied and may be triggered by intoxications, infectious diseases, metabolic disorders, CNS lesions, paroxysmal neurological disorders, and psychiatric disorders. Bizarre sensations of time alteration—such as time going backwards or moving in circles—were mostly associated with psychosis. Pathophysiologically, mainly occipital areas appear to be involved, although the temporal network is widely disseminated, with separate component timing mechanisms not always functioning synchronously, thus occasionally creating temporal mismatches within and across sensory modalities (desynchronization). Based on our findings, we propose a classification of time distortions and formulate implications for research and clinical practice.

The Secrets of Alice in Wonderland Syndrome

“…Genetic analysis of familial cases should reveal any sources of mutation or genetic disturbance in these patients [2,3]. Further intensive research is necessary to clear the origin of this mysterious syndrome [24][25][26][27][28][29][30][31][32][33][34].…”

On Perception and Consciousness in HPPD: A Systematic Review

“…It would seem that these neuron populations are largely under the control of acetylcholine. Time distortions, in turn, would seem to be mainly associated with dopaminergic dysfunction (Rammsayer, 2009 ; Jones and Jahanshahi, 2011 ; Blom et al, 2021 ). How cannabinoids, empathogens, dissociatives, hallucinogens, and stimulants all trigger HPPD symptoms through all those different working mechanisms is, as yet, unknown.…”

Entropy, Amnesia, and Abnormal Déjà Experiences

“…In the characterizations laid out in other parts of this paper, it would be more accurate to say there is no objective external arrow of time of any relevance, but changes in brain activity and brain entropy, in particular in déjà vécu cases, do have an effect on the magnitude, if not the direction, of time' s arrow. An even stronger link can be found in that lower body temperature was found in an Alzheimer' s model (Vandal et al, 2016) and linked to the disease progression, and thermal dysregulation is an oftennoted characteristic of schizophrenic patients (Chong and Castle, 2004), who also have significant rates of abnormal time experiences (Blom et al, 2021) and déjà vécu (Stanghellini et al, 2016). Lastly, thermoregulation circuits are both affected by, and can play a role in, the development of seizures (Pollandt and Bleck, 2018).…”