Migraines are a type of headache that causes throbbing pain, usually on one side of the head. The pain intensity can range from moderate to severe and may be accompanied by nausea, vomiting and sensitivity to light and/or sound. Pain symptoms increase with activity. A migraine may last from 4 to 72 hours.

According to the National Headache Foundation, about 29.5 million Americans get migraines. The condition is three times more common in women than in men. Symptoms can be triggered by certain foods or medications, changes in the sleep cycle, delaying or missing a meal, exposure to bright light or excessive noise.

About 20 percent of migraine patients experience warning signs, called an aura, about 20 minutes to one hour prior to the onset of the headache. Most auras consist of visual symptoms, like the appearance of flashing lights, wavy lines, dots or blind spots in vision. Some people develop other symptoms, like numbness or tingling in the arm or face and difficulty speaking.

Alice in Wonderland Revisited

A small percentage of migraine patients with aura develop unusual visual hallucinations. William Young, M.D., a Neurologist at Thomas Jefferson Hospital, says sometimes patients have the perception that they are very small and others around them are very tall. Another time the person may feel like a giant in a room full of wee people. Sometimes the room appears to be out of proportion in size or the floor and walls are off balance. These strange sensations have been dubbed the “Alice in Wonderland syndrome,” named after Lewis Carroll’s book describing similar characteristics in Alice’s adventures. In fact, some researchers believe Carroll drew the idea for his story from his personal experiences with migraine aura symptoms.

Young says the visual auras associated with Alice in Wonderland syndrome can be very disorienting and frightening. Yet patients are sometimes reluctant to talk about them or seek help because the symptoms are so unusual. He stresses that it’s important to seek help because the visual signs can sometimes be caused by other serious conditions, like encephalitis or seizures.

Young says there is little that can be done to treat an aura. But there is medication patients can take to prevent the onset of a migraine. It’s also reassuring to patients that once the headache symptoms are gone, visual perceptions return to normal.

For general information on migraines:

American Headache Society

Migraine Aura Foundation

Migraine Research Foundation

National Headache Foundation

National Institute of Neurological Disorders and Stroke