Dreamy mental states in late 20th century neurology

Abstract

In 1895 Sir James Crichton-Browne lectured on the dreamy mental states that had largely gone unnoticed until his old friend John Hughlings Jackson had first recognized them nearly 20 years earlier as a component of some epileptic seizures. In 1897 Jackson described the association between such dreamy states and pathology in the uncinate gyrus of the brain, thus delineating the phenomenon of uncinate (temporal lobe) epilepsy. Crichton-Browne's account of dreamy states is easier to follow than Jackson's various writings on the subject, and makes it clear that such states are not always epileptic in nature. Jackson believed that epileptic dreamy states were not due to the brain areas responsible being involved by the epileptic discharge itself, but were release phenomena resulting from the discharge inactivating higher levels of brain function. In the century since Jackson, there has been little advance in understanding of the detailed mechanisms of production of the various abnormal psychic experiences which occur in these dreamy states which, following Kinnier Wilson's analysis 1928, are now more usually considered in terms of their individual components.