Status Dissociatus and Its Relation to RBD

  • Elena Antelmi
  • Giuseppe Plazzi


The simultaneous occurrence of behavioral, neurophysiological, and autonomic descriptors conventionally defines each physiologic state of being. When functional or anatomical abnormalities involve the structures of the network orchestrating the synchronization of these descriptors, features of a state of being are erroneously recruited into an ongoing state, generating aberrant conditions. Several deviant patterns may occur, such as hypnagogic or hypnopompic hallucinations, automatic behaviors, sleep drunkenness, cataplexy, and sleep paralysis due to intrusion of other states of being while awake; REM sleep behavior disorder and lucid dreaming due to the intrusion of features of wakefulness while in REM sleep; and the disorders of arousal, for the intrusion of features of wakefulness while in NREM sleep (according to the conventional way or interpretation adopted in the chapter).

Status dissociatus labels the extreme expression of the breakdown in the boundaries of state determinants. It ranges from conditions characterized by state instability with subcontinuous state transitions, as seen in autoimmune encephalitis and type 1 narcolepsy, to extreme conditions where state of being can no longer be identified.


REM sleep behavior disorder Oneiric stupor Status dissociatus Narcolepsy Autoimmune encephalitis Agrypnia excitata 



Dominant cerebellar ataxia, deafness, and narcolepsy


Contactin-associated protein 2


Cerebrospinal fluid






Guillain-Barré syndrome




Leucine-rich glioma-inactivated 1


Multiple system atrophy


Type 1 narcolepsy




Parkinson’s disease


Periodic leg movements




REM sleep behavior disorder


Rapid eyes movement


REM sleep without atonia


Status dissociatus


REM sleep onset periods


Voltage-gated potassium channel complex antibodies




Note Added in Proof

An additional case has recently been published: 1) Puligheddu M, Congiu P, Laccu I, et al. Overlap parasomnia disorder in a case of Creutzfeldt-Jakob disease. Sleep Med. 2017;36:75–7.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Elena Antelmi
    • 1
    • 2
  • Giuseppe Plazzi
    • 1
    • 2
  1. 1.Department of Biomedical and Neuromotor SciencesAlma Mater Studiorum, University of BolognaBolognaItaly
  2. 2.IRCCS Institute of Neurological SciencesBolognaItaly

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