Twilight state: what it is, symptoms and causes
This type of alteration of consciousness causes a narrowing of the attentional capacity.
Epileptic disorders, brain lesions due to any cause or the abusive consumption of substances such as alcohol can cause the appearance of twilight states, characterized by the narrowing of the field of consciousness and by the presence of automatic and involuntary movements.
In this article we will describe what the twilight state is and what are its symptoms and its most common causes. and its most common causes. We will dwell especially on the associations between this phenomenon and broader psychological disorders, as well as on its two most typical observable signs: automatisms and impulsions.
What is the twilight state?
The twilight states are transient disturbances of alertness, attention and consciousness.. It is associated with sensations of mental confusion, temporo-spatial disorientation, decreased sensory reactivity, amnesia of episodes and automatic and impulsive behaviors. However, there is no clouding of consciousness.
The alteration of consciousness characteristic of twilight states can have a very different degree in each case. Moreover, the different areas that make up consciousness are not affected equally, but each attentional function may present more or less significant alterations.
These phenomena generally appear in broader contexts; in this regard, the following are of particular relevance epileptic disorders and the abuse of certain types of substances are particularly relevant.. Thus, the set of symptoms that we call "twilight state" is mainly due to cerebral alterations, whether of a temporary or chronic nature.
In general, twilight states have an abrupt onset and an abrupt end, and usually last several hours; it is not uncommon for them to last for days. Their intensity may vary depending on the severity of the brain disturbances causing the symptoms. The person usually has no memory of the episode once it is over.
Narrowing of the field of consciousness.
The twilight state is included in the category of the alterations due to the alterations due to narrowing of the field of consciousness.characterized by a dissociation between observable behavior and cognitive phenomena: the flow of thoughts and perceptions is interrupted but behavior continues to appear more or less normal.
However, in this type of disorder, of which twilight states are the most representative example, behavior has an automatic character. This is manifested in the appearance of automatisms (continuations of movements prior to the episode) and impulsions, which lead to ambulation.
In alterations due to narrowing of the field of consciousness, there is a decrease in the level of cerebral alertness, and therefore in the attention capacity. As a consequence, disorientation appears, both spatially and temporally, and amnesia of the episode is produced once it has ended.. Sensory reactivity is partly maintained.
Main symptoms: automatisms and impulsions.
The automatisms and the impulsions are the main signs of the twilight state and the alterations due to the narrowing of consciousness in general. and of the alterations by narrowing of the consciousness in general. They are the clearest manifestations of the impairment of consciousness and automatic behaviors that define this type of phenomena.
The term "automatism" refers to episodes of motor activity that occur with a diminished level of consciousness, and therefore have an automatic character.and therefore have an automatic and involuntary character. The coordination of movements is more or less satisfactory, although the narrowing of consciousness is usually evident to observers.
The most common automatisms involve manual gestures, walking movements, facial expressions (those of perplexity and fear are very characteristic) or words and other sounds. Chewing automatisms are especially frequent. In general, these phenomena reproduce the behavior that the person performed before the episode.
Impulsions are less common than automatisms.. They are impulsive behaviors that do not derive from a cognitive and voluntary basis, and the most common is wandering, which consists of the person walking aimlessly for an extended period of time, sometimes throughout the entire episode.
Causes of the twilight state
The typical cause of twilight states is epileptic seizures, which occur as a result of disturbances in the electrical activity of the brain. In this sense we can associate the term to the term can be associated with grand mal seizures, and in particular with the epileptic aura, i.e. the set of symptoms of epileptic seizures.that is, to the set of symptoms and signs that precede the seizures in these cases.
Another common cause of twilight state is intoxication by psychoactive substances. A type of twilight state to which special attention has been devoted is the alcoholic variant, in which the combination of one of these episodes and the consumption of alcohol, even in small quantities, can provoke very aggressive behavior.
Brain lesions and alterations of other types, in addition to those typical of epilepsy, also sometimes cause alterations due to narrowing of the field of consciousness. In this sense we can highlight ictal twilight states, during which wandering impulses are very frequent..
The literature on twilight states also mentions their association with other phenomena: schizophrenia, somnambulism and hysteria are perhaps the most relevant. However, there is not much information regarding the differential characteristics of the twilight state in these psychopathological contexts.
In conclusion
The twilight state is a mental disturbance that affects several higher psychological processes which, because of their complexity, make this phenomenon complicated to treat. Epilepsy in general, altered states of consciousness due to substance abuse, and brain injuries and all that they entail, trigger processes that involve many parts of the brain, and their effect spreads affecting many groups of neurons, so it is very complicated to locate what is the root of what happens in cases of twilight state.
Thus, it is necessary that scientific research continues to progress in order to know the main cause of this phenomenon and to be able to remedy it.
(Updated at Apr 13 / 2024)