dreamy state

   Also referred to as dreamy mental state and intellectual aura. The term dreamy state was introduced in or shortly before 1879 by the British neurologist John Hughlings Jackson (1835-1911), as a somewhat paradoxical replacement for the term intellectual aura, introduced by him in 1876. Over the years, both notions came to designate a brief state of over-consciousness (i.e. a heightened intellectual state) occurring either in isolation or during the onset of an epileptic seizure. Phe-nomenologically, this state of over-consciousness is characterized by simple or complex experiential phenomena. Simple phenomena occurring in the context of the dreamy state are conceptualized by Jackson as a false sense of reminiscence, i.e. what today is commonly referred to as *déjà vu.The complex dreamy states, also referred to as voluminous mental states, are considered to be more diverse in character. For Jackson they included the feeling that one is losing touch with the world or that one is somewhere else (i.e. derealization), as well as a loss of personal identity, deprivation of corporeal substance (i.e. depersonaliza-tion), * ecstatic states, states of profound despair, and a state called * double consciousness. The relation between these states on the one hand, and epileptic seizures on the other was summarized by the British neurologist James Crichton-Browne (1840-1938): "The dreamy mental state of one kind or another is not rarely the introduction to an epileptic fit and in that case is designated as an intellectual aura or warning." Patho-physiologically, Jackson attributed the dreamy state to a * release phenomenon preceding an actual epileptic seizure affecting the midtem-poral region. In 1899 he reported on various additional phenomena occurring at the onset of epileptic seizures, associating these with what he then called the group of uncinate fits or unci-nate epilepsies (of which the dreamy state constitutes only one group of clinical varieties). However, both Jackson and Crichton-Browne believed that not all dreamy states should necessarily be attributed to epileptic activity. Today the dreamy state tends to be classified as a partial epileptic seizure or * aura. As such, it may be complicated by associated symptoms such as * gustatory hallucinations, * olfactory hallucinations, "auditory hallucinations, unusual epigastric sensations (i.e. *abdominal aura), and motor "automatisms (notably repetitive motions of sniffing, smelling, or smacking of the lips). Although Jackson's name is inextricably connected with the notion of the dreamy state, the clinical phenomenon itself had previously been described by authors such as the French psychiatrists Théodore Herpin (1799-1865), and Jean Pierre Falret (1794-1870).

   References

   Eadie, M.J. (1998). Dreamy mental states in late 20th century neurology. Journal of Clinical Neuroscience, 5, 157-160.

   Hogan, R.E., Kaiboriboon, K. (2003). The "dreamy state": John Hughlings-Jackson's ideas of epilepsy and consciousness. American Journal of Psychiatry, 160, 1740-1747.

   Jackson, J.H. (1888). On a particular variety of epilepsy ('intellectual aura'), one case with symptoms of organic brain disease. Brain, 11, 179-207.