Twilight state: what it is, symptoms and causes

Seizure disorders, brain damage from any cause or the abuse of substances such as alcohol can cause the onset of twilight states, characterized by the narrowing of the field of consciousness and the presence of automatic and involuntary movements.

In this article we will describe what is the twilight state and what are its symptoms and causes more common. We will focus in particular on the associations between this phenomenon and broader psychological disorders, as well as its two most typical observable signs: automatisms and impulses.

    What is the twilight state?

    The twilight states are transient alterations in alertness, attention and consciousness. It is associated with feelings of mental confusion, temporal and spatial disorientation, decreased sensory responsiveness, episode amnesia, and automatic and impulsive behaviors. However, there is no disturbance of consciousness.

    The alteration of consciousness characteristic of twilight states can have a very different degree in each case. In addition, the different areas that make up consciousness are not affected in an equivalent way, but each attentional function can present more or less significant alterations.

    These phenomena generally appear in larger contexts; in this sense, they are particularly relevant seizure disorders and drug addiction. Thus, the set of symptoms that we call “twilight state” is mainly due to cerebral alterations, whether temporary or chronic.

    In general, twilight states have an abrupt onset and end and usually last for several hours; it is not uncommon for them to last for days. Its intensity may vary depending on the severity of the brain disorders causing the symptoms. The person usually does not remember the episode after it is over.

      Narrowing of the field of consciousness

      The twilight state falls into the category of alterations by narrowing the field of consciousness, Which are characterized by the dissociation between observable behavior and cognitive phenomena: the flow of thoughts and perceptions is interrupted but the behavior always has a more or less normal aspect.

      However, in this type of disorder, of which the twilight states are the most representative example, the behavior is automatic. This is manifested by the appearance of automatisms (following the pre-episode movements) and impulses, which lead to ambulation.

      In alterations by narrowing the field of consciousness, there is a decrease in the level of cerebral vigilance, and therefore in the capacity for attention. Therefore, there is disorientation, both spatial and temporal, and episode amnesia occurs after it is over. Partial sensory responsiveness is maintained.

      Main symptoms: automatisms and impulses

      Automations and pulses are the main signs of the twilight state and alterations by constipation of consciousness in general. These are the clearest manifestations of affectation of consciousness and automatic behaviors that define this type of phenomenon.

      The term “automation” refers to episodes of motor activity that work with a decrease in level of consciousness, And therefore have an automatic and involuntary character. The coordination of movements is more or less satisfactory, although the narrowing of consciousness is generally evident to observers.

      The most common automatisms involve manual gestures, walking movements, facial expressions (those of bewilderment and fear are very characteristic) or words and other sounds. Masticatory automatisms are particularly common. In general, these phenomena reproduce the behavior performed by the person before the episode.

      Readers are less common than automations. These are impulsive behaviors that do not arise from a cognitive and voluntary basis, and the most common is walking, which involves the person walking aimlessly for a long period of time, sometimes throughout the episode.

      Causes of the twilight state

      The typical cause of twilight states is epileptic seizures, which occur as a result of changes in the electrical activity of the brain. In this sense, we can associate the term a severe epileptic seizures, and in particular in the epileptic auraIn other words, to all the symptoms and signs that precede the seizures in these cases.

      Another common cause of the twilight state is intoxication with psychoactive substances. One type of twilight state to which special attention has been paid is the alcoholic variant, in which the combination between any of these episodes and the consumption of alcohol, even if it is in small amounts, can lead to very behaviors. different.

      Other types of brain damage and alterations, in addition to those typical of epilepsy, also sometimes cause alterations due to the narrowing of the field of consciousness. In this sense, we can highlight ictal twilight states, in which ambulatory impulses are very frequent.

      Its association with other phenomena is also mentioned in the literature on the twilight state: schizophrenia, sleepwalking 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.

      final

      Twilight is a mental disorder that affects many higher psychological processes which, due to their complexity, make this phenomenon difficult to treat. Epilepsy in general, altered states of consciousness due to substance use, and brain damage and all that they involve, trigger processes involving many parts of the brain, and their effect spreads affecting many groups. of people. Neurons, so it is very difficult to locate what is the root of what happens in the twilight state.

      Scientific research must therefore continue to progress in order to know the main cause of this phenomenon and be able to remedy it.

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